{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T10:05:23Z","timestamp":1753869923348,"version":"3.41.2"},"reference-count":42,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2025,2,26]],"date-time":"2025-02-26T00:00:00Z","timestamp":1740528000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["UL1 TR 002384 (REDCap use)"],"award-info":[{"award-number":["UL1 TR 002384 (REDCap use)"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["PM&amp;R"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Calcific rotator cuff (RTC) tendinopathy is a self\u2010limited, atraumatic cause of shoulder pain. Ultrasound\u2010guided percutaneous needling and aspiration (USPNA) can be used when other nonoperative treatments fail.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To determine if there is an association between morphology of RTC calcifications on imaging and the ability to aspirate calcifications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Case series.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Tertiary orthopedic institution.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients<\/jats:title><jats:p>A total of 272 patients who underwent USPNA for symptomatic calcific RTC tendinopathy and had available imaging and clinical data.<\/jats:p><\/jats:sec><jats:sec><jats:title>Interventions<\/jats:title><jats:p>Imaging was categorized using G\u00e4rtner\u2013Heyer (x\u2010ray), Farin\u2013Jaroma (ultrasound), and Chiou (ultrasound) morphological classifications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main Outcome Measures<\/jats:title><jats:p>Percentages of successful and unsuccessful aspirations were calculated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were 292 USPNA cases; 170 (58.2%) aspirations were successful. Inter\u2010rater reliability was almost\u2010perfect for Farin\u2013Jaroma and Chiou classifications (kappa: 0.92\u20131.00; <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001) and fair\u2010to\u2010moderate for G\u00e4rtner\u2013Heyer classifications (kappa: 0.38\u20130.74; <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001). When applying the G\u00e4rtner\u2013Heyer classification, 92\/134 (68.7%) type I, 65\/117 (55.6%) type II, and 10\/35 (28.6%) type III calcifications were successfully aspirated (<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001). Six calcifications could not be classified. No statistical difference was appreciated when using Farin\u2013Jaroma (<jats:italic>p<\/jats:italic>\u2009=\u2009.939) or Chiou (<jats:italic>p<\/jats:italic>\u2009=\u2009.524) classifications. The mean calcification size for successful aspirations was significantly larger than that for unsuccessful aspirations (16.7\u2009\u00b1\u20096.4\u2009mm vs. 13.4\u2009\u00b1\u20097.5\u2009mm; <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001), although there was no difference in ability to aspirate single versus multiple calcifications. The regression analysis showed an association between increasing calcification size and greater odds of aspiration success (10% increase; <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001). Compared with type I G\u00e4rtner\u2013Heyer classifications, type II and type III were associated with decreased odds of aspiration success (64% and 91% decreases, respectively; <jats:italic>p<\/jats:italic>\u2009\u2264\u2009.003).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>G\u00e4rtner\u2013Heyer classification was associated with the ability to successfully aspirate calcifications; type I calcifications were most frequently aspirated. Larger calcifications were also more frequently aspirated successfully. These factors may improve patient selection for USPNA. Further studies are needed to explore whether imaging classifications of RTC calcifications are correlated with patient\u2010reported outcomes following USPNA.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pmrj.13347","type":"journal-article","created":{"date-parts":[[2025,3,11]],"date-time":"2025-03-11T18:53:24Z","timestamp":1741719204000},"page":"782-792","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Correlation between aspiration of calcific rotator cuff tendinopathy and morphology on imaging"],"prefix":"10.1002","volume":"17","author":[{"given":"Heidi","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Physiatry Hospital for Special Surgery  New York New York USA"},{"name":"Department of Physical Medicine and Rehabilitation Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8458-619X","authenticated-orcid":false,"given":"Jennifer","family":"Cheng","sequence":"additional","affiliation":[{"name":"Department of Physiatry Hospital for Special Surgery  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jefferson","family":"Tsai","sequence":"additional","affiliation":[{"name":"Department of Physiatry Hospital for Special Surgery  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rachel D.","family":"Rothman","sequence":"additional","affiliation":[{"name":"Department of Physiatry Hospital for Special Surgery  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph","family":"Bonanno","sequence":"additional","affiliation":[{"name":"Department of Physiatry Hospital for Special Surgery  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Douglas N.","family":"Mintz","sequence":"additional","affiliation":[{"name":"Department of Radiology and Imaging Hospital for Special Surgery  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9689-4090","authenticated-orcid":false,"given":"Jonathan S.","family":"Kirschner","sequence":"additional","affiliation":[{"name":"Department of Physiatry Hospital for Special Surgery  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6282-2630","authenticated-orcid":false,"given":"James F.","family":"Wyss","sequence":"additional","affiliation":[{"name":"Department of Physiatry Hospital for Special Surgery  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,2,26]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-199005000-00017"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.5435\/00124635-199707000-00001"},{"issue":"1","key":"e_1_2_8_4_1","first-page":"186","article-title":"Rotator cuff calcific tendinopathy: from diagnosis to treatment","volume":"89","author":"Chianca V","year":"2018","journal-title":"Acta Biomed Ateneo Parm"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10195-015-0367-6"},{"key":"e_1_2_8_6_1","first-page":"63","article-title":"Calcific tendinopathy of the shoulder: clinical perspectives into the mechanisms, pathogenesis, and treatment","volume":"10","author":"Sansone V","year":"2018","journal-title":"Orthop Res Rev"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1941.02820220019004"},{"issue":"6","key":"e_1_2_8_8_1","first-page":"325","article-title":"Calcifications of the shoulder. 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