Follow the ultrasound of calcification and relieve the pain of the striking waves

How exactly does wart-wound diagnosis and therapy work and why are so promising Rainer Berthold, an expert of the German Society for Ultrasound in Medicine e.V. (Degumi).

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The calcareous shoulder clings to lime in the shoulder straps. Causes can be mechanical factors as well as local circulatory or metabolic disorders. "Movements over the head, but also on the back or on the side of stress are extremely painful," says Dr. Rainer Berthold, one of the deputy DEGUM surgeons, described the symptoms of calcareous shoulders. The variety of discomfort makes the stem appear as a chameleon. Due to severe pain patients often have difficulty moving their arms and can not lie on the affected shoulder; Blending position can even reach the shoulder stiffening.
The ankle shoulder is affected by persons between the ages of 35 and 50, of which two-thirds are women. The disease is usually diagnosed rather late, because as long as the deposits are small, they do not cause any symptoms. It can be assumed that asymptomatic carbonate hearth causes about 40 percent of symptoms later. "We can confirm the suspicious diagnosis we received because of the symptoms and limitations of movement, with ultrasound and x-ray examination," explains Dr. Med. Berthold. "Compared to MRI, this combination is very accurate and is fast and profitable."
Why lime buildup is not yet fully clarified. One of the causes may be lack of blood flow, and therefore lack of oxygen in the shoulders of the shoulders. Therapeutic approach is therefore the activation of metabolism – and hence the circulation – through the targeted movement. Special stretching exercises help relieve pain. If necessary, the doctor also prescribes pain and inflammatory drugs to help short-term patients who are often severely restricted in their daily lives and at work. Sometimes physiotherapists also use therapeutic ultrasound to treat pain.
As long as the patients agree with their complaints, one can usually expect a benign spontaneous course of illness. Calcifications often disintegrate again over time – but it may take months and is associated with severe pain. In large calcifications, the patient is sometimes advised of surgery. A mild alternative to this, however, can be a wave-wound therapy. The benefits of treatment in terms of improving symptoms and reducing calcium deposits have now been proven in many studies. Doctors use ultrasound therapy not only for diagnosis but also for more precise treatment.
In focused extracorporal wave shock therapy (ESWT), impulses are generated outside the body by means of so-called piezoelectrics, which become effective within the body. During the treatment of the calcarous shoulder, the doctor specifically directs the focused shock waves to the calcification dump in the shoulder of the shoulder. This focus can be calculated and adjusted to the device depending on the lithium deposit position. The impact wave effect can then be aligned exactly to the desired zone. This does not affect the tissue around lime deposits – so that the skin, muscles and connective tissue. "It is often assumed that shocks are destroying lime deposits, but this is not true – on the contrary, the impulse under pressure causes induction of cellular reactions," explains Dr Med Berthold. "Increased blood flow by neovascularization in the affected area leads to dissolving calcium deposits."
Alternatively, there is also a cheaper radial wave shock therapy. Usually it works with compressed air. The impact of the projectile on the applicator creates unfocused pressure waves. However, the efficiency of this low-energy method is lower – the number of treatments required is usually higher.
The claim belongs to the Individual Health Services (IGeL) for legally insured persons; the patient has to bear the costs. Most private funds and auxiliary agencies take over treatment. "One to three treatments, each lasting ten minutes, are usually sufficient for a focused shock," Dr. Berthold. "Side effects are small, patients are often painless and moveable in the shoulder by this gentle procedure." Disease duration is shortened and surgery can usually be prevented. ESWT can be carried out with the prior localization of lime deposits by sonography in my experience more accurately. "

Source: F. Dehlinger, T. Ambacher. Stone coat. Orthopedics and Traumatology up2data 2014; 439-458

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About the DEGUM:
The German Society for Ultrasound in Medicine (DEGUM) offers a forum for scientific and practical exchange of experience in the field of medical ultrasound. It gathers around 10,000 physicians from various areas, medical assistants, scientists and technicians. Ultrasonic diagnostics today is the most widely used image in medicine. Ultrasound users certify the DEGUM qualification with level I to III certification. Patients on the Internet find DEGUM certified doctors at:

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Press contact:
Office for Media of German Society for Ultrasound in Medicine e.V. (Degumi)
Katharina Weber
Mailbox 30 11 20
70451 Stuttgart
Tel.: 0711 8931-583
Fax: 0711 8931-167
E-mail:

Original Issues:
F. Dehlinger, T. Ambacher. Stone coat. Orthopedics and Traumatology up2data 2014; 439-458

idw 2019/07