An interventional study of Ultrasound guide localization and Palpation localization in Calcific Tendinitis of Shoulder, sponsored by Taipei Medical University WanFang Hospital. Recruiting at 1 site in Taiwan. Open to participants aged 20 Years to 70 Years. Per ClinicalTrials.gov, last updated 2026-08-12.
Sponsored by Taipei Medical University WanFang Hospital · Not applicable, Interventional, and Treatment
Calcific tendinitis of the shoulder is a debilitating musculoskeletal condition that significantly impacts the working-age population, typically those between 30 and 60 years of age. Accounting for approximately 7- 17% of shoulder pain complaints, it is characterized by the pathological deposition of calcium hydroxyapatite crystals within the rotator cuff tendons, most notably the supraspinatus. The progression of the disease, particularly during the resorptive phase described in Uhthoff's cycle, is associated with a dramatic increase in intratendinous pressure and severe inflammatory pain, leading to substantial functional impairment and socioeconomic burden. While Extracorporeal Shock Wave Therapy (ESWT) is a well established non-invasive modality known to promote calcific resorption via cavitation effects and mechanotransduction-induced neovascularization, its clinical efficacy remains highly variable across current literature, with success rates ranging widely from 47% to 87%. This inconsistency is largely attributed to the limitations inherent in conventional "blind" or landmark-based targeting techniques. Given that calcific deposits are often small, deeply situated, or obscured by the acromion, palpation-guided targeting is frequently unreliable, resulting in suboptimal energy delivery to the pathology and potential collateral damage to surrounding healthy tissues. This one-year research project aims to evaluate the superior efficacy of "Real-time Ultrasound-Guided" ESWT compared to conventional methods. The investigators propose a prospective, randomized, double-blind, controlled trial (RCT) that will recruit 60 patients with confirmed calcific tendinitis. Participants will be stratified by Gärtner classification (Type I-III) to ensure balanced morphological distribution and then randomized into either an experimental group receiving Ultrasound-Guided Focused ESWT or a control group receiving Landmark-based/Sham ESWT. The study incorporates rigorous methodology, including a priori power analysis for sample size estimation, strict allocation concealment, and assessor blinding. Outcomes will be assessed at baseline, 4, and 12 weeks post-treatment. Primary outcomes include the Constant-Murley Score (CMS) and Visual Analog Scale (VAS), while secondary outcomes involve quantitative ultrasound analysis using ImageJ software to measure the reduction in calcific deposit volume and assess tendon integrity. The investigators hypothesize that the integration of realtime ultrasound guidance will significantly enhance therapeutic precision, leading to higher rates of calcific resorption and functional recovery. The findings are expected to provide high-level evidence to standardize ESWT protocols, thereby advancing the implementation of precision medicine in the field of physical and rehabilitation medicine.
57 studies on the registry are indexed under Rotator Cuff Tear Arthropathy; 15 are open to participants now.
This study's planned enrollment of 60 is below the median of 90 across 33 interventional studies indexed under Rotator Cuff Tear Arthropathy.
Browse Rotator Cuff Tear Arthropathy studies →Taipei Medical University WanFang Hospital is the lead sponsor of 201 studies on the registry; 20 are open to participants now.
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Exclusion Criteria:
Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.
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Malignancy means cancer. Criteria about another or earlier malignancy ask whether you have had a different cancer, usually within a set number of years.
Some are commonly allowed, such as treated skin cancers other than melanoma and early cancers removed completely — check the exceptions this study lists.
Informed consent
Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.
You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Cancer (malignancy)
Malignancy means cancer. Criteria about another or earlier malignancy ask whether you have had a different cancer, usually within a set number of years.
Some are commonly allowed, such as treated skin cancers other than melanoma and early cancers removed completely — check the exceptions this study lists.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Ultrasound image guided the depth and location of calcification point, Perform ESWT for calcific tendonitis of shoulder
Procedure: Ultrasound guide localization
Palpation and depends the feedback of participants localization of ESWT points
Procedure: Palpation localization
Use ultrasound guided localization of calcific tendonitis of shoulder and then perform Extracorporeal Shock Wave Therapy, ESWT 0.12 to 0.25 mJ/mm 6000 times
Use palpation localization of calcific tendonitis of shoulder and then perform Extracorporeal Shock Wave Therapy, ESWT 0.12 to 0.25 mJ/mm 6000 times
Change in Constant-Murley Score (CMS)
The Constant-Murley Score is a clinician-administered instrument assessing shoulder function across four domains: pain (15 points), activities of daily living (20 points), range of motion (40 points), and strength (25 points), for a total score of 0-100. Higher scores indicate better shoulder function. The measure compares real-time high-resolution ultrasound-guided focused ESWT (experimental) with X-ray plus palpation-guided focused ESWT (control) for calcific tendinitis of the shoulder. Assessed at baseline, Week 4, and Week 12; change from baseline is reported.
Time frame: Baseline, Week 4, and Week 12 after the start of treatment (primary endpoint at Week 12)
Change in Pain Visual Analog Scale (VAS)
Pain intensity is self-reported on a 0-10 Visual Analog Scale, where 0 = no pain and 10 = worst imaginable pain. Ratings are collected for pain at rest, pain with activity, night pain, and average pain over the past week. Higher scores indicate greater pain. Change from baseline is compared between the ultrasound-guided ESWT and landmark (X-ray + palpation)-guided ESWT groups. Assessed at baseline, Week 4, and Week 12.
Time frame: Baseline, Week 4, and Week 12 after the start of treatment (primary endpoint at Week 12)
Change from Baseline in Shoulder Pain and Disability Index (SPADI)
Patient-reported questionnaire comprising a 5-item pain subscale and an 8-item disability subscale, each item scored 0-10. Subscale and total scores are expressed as percentages (0-100%), with higher scores indicating greater pain and disability.
Time frame: Baseline, Week 4, Week 12
Calcific Deposit Resorption Rate
Calcific deposit dimensions (long axis, short axis, area, and estimated volume) are quantified from ultrasound images using ImageJ software. Percentage volume reduction from baseline is calculated. Resorption is additionally categorized as complete, partial (\>50%), partial (\<50%), unchanged, or increased.
Time frame: Baseline, Week 4, Week 12
Change from Baseline in Shoulder Range of Motion (ROM)
Active and passive range of motion measured in degrees with a goniometer for forward flexion, abduction, external rotation at 90° abduction, and internal rotation at 90° abduction.
Time frame: Baseline, Week 4, Week 12
Tendon Structural Integrity on Ultrasound
Supraspinatus (or affected) tendon integrity graded on high-resolution ultrasound as intact, partial-thickness tear, or full-thickness tear. Tendon thickness is recorded in millimeters.
Time frame: Baseline, Week 4, Week 12
Patient Global Impression of Change (PGIC)
Single-item 7-point scale ranging from 1 (very much improved) to 7 (very much worse), capturing the participant's overall perceived change since starting treatment.
Time frame: Week 4, Week 12
Plan to share: Yes — De-identified individual participant data (IPD) that underlie the results reported in the publication (including text, tables, figures, and appendices) will be shared. This includes baseline characteristics, intervention adherence, and primary and secondary outcome measures. Additionally, the study protocol, statistical analysis plan (SAP), and data dictionary will be made available.
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Rotator Cuff Tear Arthropathy →
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