Biceps brachii long head calcific tendinitis can be treated quickly and effectively with radial shockwave therapy: a case report
Yavuz Şahbat1
, Görkem Çat1, İlker Yağcı2, Osman Mert Topkar1
1Department of Orthopaedic Surgery and Traumatology, Marmara University, İstanbul, Türkiye
2Department of Physical Therapy and Rehabilitation, Marmara University, İstanbul, Türkiye
Keywords: Biceps brachii, shoulder, shockwave therapy, calcium deposit
Abstract
Calcific tendinitis, which mostly involves the supraspinatus and rotator cuff tendons, may very rarely involve the long head of the biceps brachii (LHBB). Arthroscopy is the first choice in cases of calcific tendinitis accompanied by a rotator cuff tear but in cases where the rotator cuff is intact, there are different treatment methods, such as non-steroidal anti-inflammatory drugs (NSAID), steroid injection, Extracorporeal Shock Wave Therapy (ESWT), and Radial Shock Wave Therapy (RSWT).
A 28-year-old male presented at the outpatient clinic with right shoulder pain which had been ongoing for 6 months. The patient, who was a licensed table tennis player and amateur bodybuilder, had no systemic diseases. After clinical and radiological evaluation, ultrasonography showed calcification at the level of the greater tuberculum of the right humerus. The patient was diagnosed with calcific tendinitis of the bicipital tendon. Magnetic resonance imaging (MRI) was then performed to investigate any rotator cuff pathology or glenohumeral joint pathology. No additional pathology was observed. The patient was managed with the standard RSWT protocol of four sessions. 0.25 mJ/mm2 3 bar 2000 beats administered with an electromagnetic lithotriptor. Before RSWT, the VAS score was 9 over 10 and Constant score was 37, and after the first session of RSWT, the VAS score of the patient had decreased to 6. After the 4th session, treatment was terminated as the patient was completely pain-free.
At the 1-year follow-up examination, the patient was still pain-free during daily activities and sports activities, and had full range of motion. In this case report, RSWT is presented as an effective treatment option for LHBB calcific tendinitis. RSWT may be a priority option over ultrasound-guided or arthroscopic barbotage in patients without tendon rupture.
Cite this article as: Sahbat Y, Cat G, Yagci I, Topkar OM. Biceps brachii long head calcific tendinitis can be treated quickly and effectively with radial shockwave therapy: a case report. Turk J Sports Med. 2024;59(1):33-8; https://doi.org/10.47447/tjsm.0752
Concept: YŞ,OMT, İY; Design: YŞ,İY; Supervision: OMT,İY; Materials: GÇ,YŞ,İY; Data Collection and/or Processing: İY,YŞ; Analysis and Interpretation: YŞ,OMT; Literature Review: YŞ,GÇ; Writing Manuscript: YŞ,GÇ; Critical Reviews: YŞ,OMT
The authors declared no conflicts of interest with respect to authorship and/or publication of the article.
The authors received no financial support for the research and/or publication of this article.
