低剂量放射治疗对肩袖钙化性肌腱炎的影响:病例报告

N. Milenović, Sonja Lukač, Silvija Lučić, Vedrana Karan Rakić, Daniel Slavić, Đurđa Cvjetković Nikoletić, Damir Lukač
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引用次数: 0

摘要

肩袖钙化性肌腱炎(RCCT)是由于肩袖肌腱内部或周围存在钙化沉积物而引起的急性或慢性疼痛病症。有效治疗 RCCT 对于恢复肩关节功能、减轻疼痛和提高患者生活质量至关重要。RCCT 的治疗主要分为手术治疗和非手术治疗。保守治疗一直被视为一线疗法,但其有效性仍未得到充分证实。当保守治疗无效时,通常会采用微创或手术等侵入性治疗。如今,低剂量放射治疗已被用于治疗各种良性疾病,包括钙化性腱鞘炎。我们接诊了一名 56 岁的女性患者,她的左肩疼痛剧烈,活动受限。左肩的 X 光片和超声波检查显示,冈上肌大部有一个巨大的椭圆形钙化,大小为 41x8mm。患者首先接受了地氯普兰、培南通凝胶和休息治疗。之后,决定尝试低剂量放射治疗。该疗法在 Vitalbeam 放射治疗平台上进行,采用适形技术,剂量为 Gy 8 和 10 次分割。最后一次分次放疗后,疼痛逐渐消失,活动能力也恢复了。最后一次治疗后 2 个月的超声波检查显示,钙化完全消失。对良性疾病使用低剂量放疗是医学界一直争论不休的话题。在这个病例中,低剂量放射治疗被证明是一种适当的选择,没有伴随的副作用,结果是完全愈合并提高了生活质量。
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Effect of low-dose radiotherapy in rotator cuff calcific tendinitis: A case report
Rotator cuff calcific tendinitis (RCCT) is an acute or chronic painful condition due to the presence of calcific deposits inside or around the tendons of the rotator cuff. Effective treatment of RCCT is crucial for restoring shoulder function, alleviating pain, and enhancing the patient’s quality of life. The treatment of RCCT is mainly divided into surgical and non-surgical treatment. Conservative treatment has been regarded as the first-line therapy, but the effectiveness of these treatments is still not well-established. When conservative treatment fails, invasive treatment, either minimally invasive or surgical, is usually indicated. Nowadays, low-dose radiotherapy has been used for the treatment of various benign conditions, including calcific tendinitis. We presented a 56-year-old female patient with intense pain and limited mobility of her left shoulder. X-rays and ultrasound of the left shoulder showed a massive oval calcification along the greater part of the m. supraspinatus measuring 41x8mm. The patient was first treated with diclopram, peranton gel, and rest. After that, it was decided to try low-dose radiotherapy. It was performed on the Vitalbeam radiotherapy platform with a conformal technique in doses of Gy 8 and 10 fractions. After the last fraction, the pain gradually disappeared and mobility was regained. The ultrasonography control 2 months after the last session showed the total disappearance of the calcification. The use of low-dose radiotherapy for benign conditions is a topic of ongoing debate in the medical community. In this case, low-dose radiotherapy proved to be an adequate method of choice without accompanying side effects, resulting in complete healing and improvement of quality of life.
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