Search Results (311)

Rotator cuff tear (RCT) is a leading cause of shoulder pain encountered by general practitioners. Population-based screening shows that nearly half of full-thickness tears are asymptomatic, allowing many lesions to progress undetected. This narrative review summarises 105 clinical, imaging, biomechanical and rehabilitation studies published in recent years. The review follows the disorder from early tendinopathy to full-thickness tear and discusses crucial risk factors (age, diabetes, hypercholesterolaemia, overhead work). It aims to guide early primary-care management of RCT. We examine the diagnostic accuracy of classic bedside tests, including the supraspinatus weakness and external rotation lag cluster. Furthermore, we explain when ultrasound or MRI adds value and what the classic findings are. An informative overview of patient-reported outcome tools (e.g., SPADI, WOSI, Constant–Murley, ASES) could help physicians select one for follow-up. The article objectively evaluates the evidence for conservative measures—structured exercise protocols, manual therapy, oral analgesics, and corticosteroid or platelet-rich plasma injections. Moreover, we propose an evidence-based postoperative rehabilitation timeline with milestones that incorporate targeted immobilisation and progressive loading. The article presents selected clinical situations, such as the impact of type 2 diabetes on tendon biology. We explore the viability of experimental adjuncts such as extracorporeal shock-wave therapy, low-intensity pulsed ultrasound and electrical stimulation. Finally, we compare recommendations from the American Academy of Orthopaedic Surgeons and the European Society for Surgery of the Shoulder and Elbow. We highlight similarities between the recommendations (e.g., overlapping clinical examination tests), thereby facilitating their clinical application and providing a pragmatic guide for general practitioners. Our synthesis draws on orthopaedic, radiographic and rehabilitation data to reduce diagnostic delay, optimise non-specialist resource use, and improve pain and functional outcomes for the growing population affected by rotator cuff tears. Full article

Ultrasound-guided hydrodissection and dextrose prolotherapy have evolved into anatomically explicit but mechanistically distinct strategies for musculoskeletal pain. This State-of-the-Art narrative review aimed to synthesize major recent clinical and technical developments and to interpret them within a target-based framework. PubMed and Embase via Ovid were searched for English-language publications from 1 January 2021 through 29 July 2026, supplemented by selected pre-2021 landmark studies identified through backward citation tracking. After initial deduplication, 1662 records entered Title/Abstract screening. The final narrative synthesis cited 67 publications, including selected landmark and methodological sources. One author performed screening, and a second author reviewed the final publication selection; study selection was purposive and designed for a narrative synthesis rather than exhaustive systematic inclusion. Four questions guided the review: recent refinements in hydrodissection technique and indications; increasing condition specificity of prolotherapy evidence; areas of overlap and distinction between the two procedures; and the evidentiary status of emerging applications. Hydrodissection research remains concentrated in carpal tunnel syndrome and increasingly addresses injectate, volume, tissue-plane spread, and procedural configuration, whereas evidence beyond the carpal tunnel remains incompletely replicated. Prolotherapy research has shifted from broad claims toward condition-specific studies in tendinopathy, plantar fasciopathy, knee osteoarthritis, periarticular disorders, and temporomandibular joint pathology. Across both fields, variations in concentration, volume, anatomical site, session number, comparator, rehabilitation, and procedural expertise limit generalization. Hydrodissection is defined by observable, fluid-mediated separation of a tissue interface, whereas prolotherapy involves dextrose delivery to a symptomatic connective-tissue target without requiring immediate tissue-plane separation. The proposed framework is intended to standardize terminology, organize evidence maturity, and guide future comparative research rather than prescribe a validated treatment algorithm. Full article

Background: Lateral epicondylalgia (LE) is a prevalent musculoskeletal condition, and a substantial proportion of patients fail to respond to conservative treatment. The myotendinous junction (MTJ) of the common extensor tendon (CET) harbors dense nociceptive nerve endings yet remains an underexplored target in pharmacopuncture practice. Case Presentation: In this retrospective case series, three patients with refractory LE (duration 1.5–3 years, with prior treatments including corticosteroid injection, NSAIDs, physical therapy, and prolotherapy) received a structured multicomponent ultrasound-guided pharmacopuncture protocol, of which MTJ-targeted hydrodissection with placenta pharmacopuncture constituted the primary component, administered over ten sessions. A structured three-stage protocol was applied, incorporating placenta pharmacopuncture at the MTJ, Eohyeol pharmacopuncture at LI11, and dry needling at the CET enthesis. Results: All three patients achieved clinically meaningful improvements in PRTEE scores (Case 1: 64→13, −79.7%; Case 2: 73→38, −47.9%; Case 3: 55→11.5, −79.1%), exceeding the MCID threshold of 37% reduction. Qualitative sonographic changes were observed at follow-up assessments conducted 103–270 days after treatment completion. No adverse events were observed. Conclusions: A structured multicomponent ultrasound-guided pharmacopuncture protocol may represent a feasible non-surgical approach for patients with refractory LE. Controlled prospective studies are warranted. Full article

Two client-owned Lionhead rabbits underwent median sternotomy for mediastinal mass excision. Premedication included methadone, dexmedetomidine, and midazolam, with ketamine added for one rabbit. Anesthesia was maintained with isoflurane in oxygen and a ketamine infusion. Bilateral ultrasound-guided TTP blocks were performed at the level of the second and fifth intercostal spaces using a linear transducer and a spinal needle advanced in-plane in a lateromedial direction. Bupivacaine 0.5% was injected at a total dose of 2 mg/kg per rabbit, divided equally among four injection sites (total volumes of 0.9 mL and 1.0 mL for the first and second rabbits, respectively). Only one rabbit exhibited a brief intraoperative nociceptive response. The second rabbit developed severe postoperative respiratory compromise related to inadequate thoracic drain function and died 4 h after surgery. These cases indicate that the TTP block is technically feasible in rabbits and can contribute to intraoperative analgesia during thoracic surgery. Further studies are needed to evaluate the optimal injectate volume and its distribution, as well as the safety and efficacy of the anesthetic dose. Full article

Background/Objectives: Ultrasound-guided flexor pollicis longus (FPL) injection is limited by the muscle’s deep location and its proximity to the cephalic vein (CV) and superficial branch of the radial nerve (SBRN). We aimed to identify the wrist and forearm posture producing the largest measured corridor width and target exposure. Methods: This prospective single-center study evaluated 51 forearms from 27 healthy adult volunteers with full range of motion, using transverse ultrasound of the distal volar forearm in six standardized positions. Two corridors were measured: CV-to-SBRN (L₁, Approach A) and CV-to-radial-cortex apex (L₂, Approach B), with FPL exposure height (F). Results: L₂ was present in all limbs and was wider with forearm supination than in neutral (supination [SUP], +2.36 mm; flexion plus supination [F+SUP], +2.05 mm; extension plus supination [E+SUP], +2.66 mm; each p < 0.001), an ~40% increase; the three supination postures did not differ. F increased across the same postures and was greatest in E+SUP (+2.32 mm), which did not differ from SUP. L₁ was absent in 12–28% of limbs and, where present, was narrower with supination (both p < 0.001). Conclusions: In healthy adults, forearm supination widened the safety corridor and increased target exposure. Applicability to spasticity requires confirmation. Full article

Background/Objectives: Interventional endoscopic ultrasound (I-EUS) has evolved from a diagnostic imaging modality into a transformative therapeutic platform encompassing biliary drainage, pancreatic interventions, luminal bypass, pain management, and ablative therapies. Despite the rapid proliferation of I-EUS research, a comprehensive bibliometric analysis characterizing the global intellectual architecture of this field is lacking. Methods: A Web of Science Core Collection search identified 4340 records, of which 2237 were included (2001–2024), analyzed with R bibliometrix (version 5.0) and VOSviewer (version 1.6.20). Results: Publication output demonstrated three distinct phases with pronounced acceleration from 2017. The United States led global output (n = 625, 27.9%), followed by Japan (n = 435, 19.4%) and Italy (n = 166, 7.42%). At the continental level, Asia collectively produced the largest share of output (n = 884, 39.5% of the total corpus), exceeding the Americas (n = 687, 30.7%) and Europe (n = 492, 22.0%). Gastrointestinal Endoscopy was the most productive journal (n = 173). Tokyo Medical University was the most productive institution (n = 93, 4.16%). Four thematic clusters were identified: EUS-guided biliary and pancreatic ductal drainage; diagnostic, ablative, and injection EUS for pancreatic tumors; LAMS-enabled luminal bypass and gallbladder drainage; and pancreatic fluid collections and necrotizing pancreatitis. Temporal overlay confirmed EUS-guided gastroenterostomy, EUS-guided gallbladder drainage, and EUS-guided radiofrequency ablation as the leading research frontiers. Annual output showed no discernible contraction during the COVID-19 pandemic period (2020–2021). Conclusions: The United States led global I-EUS research output with higher rates of international collaboration compared with East Asian nations, although Asia as a continent generated the largest aggregate volume of publications. EUS-guided biliary drainage and pancreatic fluid collection management constitute the established, high-volume core of the field, while EUS-guided gastroenterostomy and novel ablative technologies represent the most dynamic investigative frontiers. Full article

Background/Objectives: Local anesthetics (LAs) are used in a variety of different contexts, from loco-regional anesthesia to analgesia. In cardiothoracic surgery, fascial plane blocks are deserving of attention, including erector spinae plane block (ESPB). In this context, ropivacaine is convenient, due to its peculiar pharmacokinetic/pharmacodynamic properties. Nevertheless, LAs can still cause systemic toxicity (LAST), due to erroneous injection and/or variable systemic adsorption/distribution. This interindividual pharmacokinetic variability can be intensified by the tendency to use a fixed ropivacaine dose in ESPB. The aims of this work were investigating systemic exposure to ropivacaine during ESPB in the context of cardiac and thoracic surgery, comparing it to the literature-reported maximum tolerated concentrations, and identifying potential predictors of exposure. Methods: Patients receiving ultrasound-guided injection of 40 mL of ropivacaine 0.375% solution for ESPB were enrolled. Arterial blood was sampled at 5, 15, 30, 45, 60, 120, and 180 min after the injection, and total and free concentrations of ropivacaine were determined by means of LC-MS/MS analysis of arterial plasma. Results: Concentrations showed wide variability, particularly during the first hour post-dose. Significant differences were observed between patients undergoing cardiac and thoracic surgery, with the latter showing higher concentrations, potentially above the cutoff values predictive of LAST. Pharmacokinetic differences were mainly explained by anthropometric (body weight and BSA) and clinical/hemodynamic (NYHA score) characteristics. Conclusions: This study shows that about 5% of patients could reach arterial plasma concentrations of ropivacaine above the cutoff level for LAST after ESPB with a 150 mg dose. Considering patients’ weight could be beneficial to maintain exposure below the toxicity cutoff. Full article

Peripheral neuropathy constitutes a prevalent, albeit underrecognized, extraglandular manifestation of Sjögren’s disease (SjD). Carpal tunnel syndrome (CTS) commonly coexists with SjD; however, the efficacy of standard CTS treatments in this population remains insufficiently characterized. This study evaluated the clinical and biological response to local corticosteroid injection in CTS patients with and without SjD and explored factors potentially associated with treatment outcomes. Twenty patients with SjD and CTS diagnosed based on typical clinical symptoms and supportive ultrasonographic findings and 19 control subjects with idiopathic CTS underwent ultrasound-guided corticosteroid injection. Median nerve cross-sectional area (CSA), the Boston Carpal Tunnel Questionnaire (BCTQ), and the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire were assessed before treatment and 4 weeks after injection. Patients with SjD additionally underwent comprehensive clinical, laboratory, neurophysiological, and patient-reported outcome assessments. Patients with SjD appeared to demonstrate a significantly greater reduction in median nerve CSA following corticosteroid injection compared with controls (mean reduction: 0.46 vs. 0.31 mm²; p = 0.006, Cohen’s d = 0.96, CI90% [0.51, 1.49]). Despite this favorable biological response, clinical improvement was significantly smaller in the SjD group. Patients without SjD exhibited greater improvement in both the BCTQ Symptom Severity Scale (p = 0.021) and Functional Status Scale (p = 0.033), whereas changes in DASH scores did not differ significantly between groups. Patients with concomitant peripheral neuropathies experienced significantly poorer BCTQ improvement than those with isolated CTS, suggesting that neurological comorbidity may contribute to treatment resistance. No significant associations were identified between treatment response and fibromyalgia status or ESSPRI domains. Among quality-of-life measures, only the SF-36 General Health domain differed significantly between neuropathy types. Patients with SjD and CTS exhibit a dissociation between structural improvement of the median nerve and subjective symptom relief after corticosteroid injection. These findings suggest that mechanisms beyond local nerve compression, including coexisting peripheral neuropathy and potentially altered pain processing, may contribute to persistent symptoms. Comprehensive neurological assessment and multidimensional outcome evaluation may improve identification of SjD patients at risk of suboptimal response to conventional CTS therapies. Full article

BACKGROUND: Plantar fasciitis (PF)is one of the most common causes of heel pain that affecting 10 of the general population. Platelet rich plasma(PRP)has been demonstrated to be helpful in managing PF and reducing plantar facia thickness (PFT). This study objective was to know the effect and efficacy of ultrasound (USG) guided intralesional PRP in PF in relation to pain, PFT and foot function index (FFI). METHODS: A prospective interventional study was conducted in a tertiary care hospital on eighty-five diagnosed cases of unilateral PF. All patients had undergone pain intensity assessment by visual analogue scale (VAS), FFl, and USG examination of PFT after USG guided intralesional PRP injection was assessed at baseline (0 weeks), 2 weeks and 6 weeks. RESULTS: Following USG guided intralesional PRP injection,a statistically significant decrease was noted in plantar fascia thickness (PFT) from baseline 0 (week) 6. 592mm ± 0. 51mm to 5. 169mm ± 0. 39mm and reduced to 4. 07mm ± 0. 39mm at 2nd week and 6th week, respectively (P value 0. 001).A statistically significant reduction of VAS score was noted which reduced from 8. 647 ± 0. 55 to 5. 588 ± 1. 13 (2nd week) and further reduced to 1. 21 ± 1. 06 at the end of 6 weeks (p value 0. 001). Mean FFI in our study at baseline was 85. 494 ± 6. 55, at 2 weeks mean FFI was 49. 341 ± 7. 277 and the end of 6 week it reduced to 24. 235 ± 1. 608 (P value 0. 001) statistically significant decrease was noted. CONCLUSIONS: PRP injection helps in the reduction of heel pain (VAS), reduction in PFT, and improvement in all domains of FFI, leading to enhancement of quality of life. Full article

Background: Spasticity is one of the most disabling manifestations of multiple sclerosis (MS), contributing to limitations in walking and transfers, pain, progressive functional limitation, and reduced quality of life. Despite advances in rehabilitation, pharmacological therapies, botulinum toxin injections, and intrathecal baclofen, many patients continue to experience refractory focal or multifocal spasticity requiring alternative therapeutic approaches. Percutaneous cryoneurolysis has recently emerged as a minimally invasive peripheral neuromodulation technique capable of selectively reducing pathological muscle overactivity through reversible axonotmesis while preserving the structural framework necessary for nerve regeneration. Growing clinical experience has expanded its application across several neurological disorders; however, its role in MS has not yet been comprehensively defined. Methods: A structured narrative review was conducted through comprehensive searches of PubMed/MEDLINE, Scopus, and Web of Science. Original clinical studies evaluating percutaneous cryoneurolysis for neurological spasticity were identified and critically synthesized. Because disease-specific evidence in MS remains limited, studies involving other upper motor neuron disorders, including stroke, cerebral palsy, traumatic brain injury, and spinal cord injury, were also considered to provide a broader overview of current clinical applications, procedural techniques, safety, and functional outcomes. Results: The available evidence includes case reports, case series, and prospective and retrospective observational studies, together with recent evidence syntheses. Across different neurological conditions, ultrasound-guided cryoneurolysis has consistently demonstrated technical feasibility and a favorable safety profile, with reported reductions in spasticity, improvements in passive range of motion, pain reduction, facilitation of positioning and nursing care, and, in selected studies, improved functional performance. Recent observational cohorts and prospective studies have expanded the evidence base by providing larger patient populations and longer follow-up, while systematic evidence syntheses have confirmed the growing clinical interest in this technique. Nevertheless, substantial heterogeneity persists regarding patient selection, target nerves, procedural protocols, outcome measures, and duration of follow-up. Evidence specifically addressing patients with MS remains limited and is currently derived primarily from individual case reports and small clinical series. Conclusions: Current evidence suggests that percutaneous cryoneurolysis represents a promising minimally invasive adjunctive treatment for selected patients with focal or multifocal neurological spasticity, including those with multiple sclerosis. However, the available evidence remains predominantly observational, and randomized controlled trials comparing cryoneurolysis with established therapies are still lacking. Future multicenter prospective studies, standardized treatment protocols, and disease-specific investigations are required to better define patient selection, long-term efficacy, safety, and the role of cryoneurolysis within contemporary multidisciplinary spasticity management. Full article

Adhesive capsulitis (AC) is a common fibroinflammatory shoulder disorder, affecting 2–5% of the general population and up to 20% of people with diabetes mellitus. Although historically considered self-limiting, the course frequently exceeds two years and imposes a substantial functional burden. Intra-articular corticosteroids remain the predominant first-line option, but their benefit is often short-lived and is offset by transient hyperglycemia in diabetic patients, potential tissue toxicity with repeated use, and limited durability. These limitations have prompted interest in non-steroidal, ultrasound-guided alternatives. This narrative review appraises two complementary strategies: ultrasound-guided regenerative injectates (hyaluronic acid, hypertonic dextrose prolotherapy, and platelet-rich plasma) and ultrasound-guided perineural hydrodissection of the suprascapular, axillary, and subscapular nerves. We summarize comparative efficacy with corticosteroids, durability, injection anatomy, and the subgroups most likely to benefit. We then propose—explicitly as a clinically defensible framework rather than a validated guideline—a phase-specific paradigm in which a timely non-steroidal injection provides early pain control while stage-appropriate rehabilitation drives functional recovery. The hypothesis that this sequence may compress the symptomatic course to approximately three to six months is supported by preliminary evidence and requires prospective validation. Because no head-to-head trial has compared the proposed paradigm with the corticosteroid-first standard, these recommendations warrant corresponding caution. Full article

Knee osteoarthritis (OA) is increasingly recognized as a whole-joint disorder involving periarticular soft tissues in addition to intra-articular structures. A recently published technical report described an ultrasound-guided posteromedial knee injection targeting a fascial–periarticular convergence region operationally termed the popliteal fascial retinaculum. In the present study, we evaluated preliminary longitudinal clinical outcomes after this procedure in patients with mild-to-moderate knee OA. Background/Objectives: Knee OA is a common cause of chronic pain, stiffness, and disability. In the present study, we evaluated preliminary 12-month WOMAC outcomes after a three-session ultrasound-guided posteromedial fascial–periarticular injection in patients with Kellgren–Lawrence grade 1–3 knee OA. Methods: This retrospective analysis of a prospectively maintained single-center clinical registry included 10 patients treated between October 2023 and October 2025. Each patient received three monthly ultrasound-guided posteromedial injections using 30 mL of 5% dextrose with 0.1% lidocaine (lignocaine). The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) was recorded at baseline and at 1, 3, 6, and 12 months after the final injection. Data are mean ± SD, median (IQR), and 95% CI. In exploratory inferential analyses, we used Friedman tests and Wilcoxon signed-rank tests with Bonferroni correction. Results: The mean WOMAC total score improved from 59.5 ± 4.33 at baseline to 38.6 ± 4.50 at 1 month, 34.3 ± 4.45 at 3 months, 30.6 ± 3.06 at 6 months, and 28.5 ± 2.51 at 12 months after the final injection, corresponding to a mean 12-month within-patient change of −31.0 points (95% CI −32.58 to −29.42; −52.1%). Mean pain improved from 12.6 ± 1.35 to 5.6 ± 0.70, stiffness from 4.7 ± 0.48 to 2.1 ± 0.32, and physical function from 42.2 ± 2.62 to 20.8 ± 2.15. All 10 patients had lower WOMAC total scores at 12 months than at baseline. Friedman tests were significant for all four WOMAC domains (all p ≤ 5.05 × 10⁻⁷); Wilcoxon signed-rank tests versus baseline reached the theoretical minimum p at n = 10 (Bonferroni-adjusted p = 7.81 × 10⁻³) at every follow-up timepoint. No serious adverse events were documented; mild transient post-procedural soreness occurred in three patients. Conclusions: In this small retrospective pilot cohort, ultrasound-guided posteromedial fascial–periarticular injection was associated with sustained improvement in WOMAC pain, stiffness, physical function, and total scores over 12 months. These findings are preliminary and hypothesis-generating; non-specific effects including placebo, regression to the mean, and natural symptomatic fluctuation cannot be excluded. Prospective controlled trials are required to establish safety, reproducibility, mechanism, and comparative effectiveness. Full article

Reliable medical image segmentation remains challenging because models must preserve fine boundary details while maintaining global semantic consistency. CNNs capture local structures effectively but have limited long-range modeling ability, whereas Transformer-based methods improve global context at high computational cost. Mamba-based state space models offer efficient long-range modeling, but may weaken high-frequency textures and boundary cues. To address these limitations, we propose DIG-MambaNet, a Dual-path Interactive Guided Mamba Network for medical image segmentation. The network introduces a dual-path complementary modeling block (DCM Block), where a cross-feature spatial interaction module (CSIM) adaptively integrates CNN-based local features and Mamba-based global features. A source image-guided module (SIGM) injects high-frequency information from the original image to compensate for downsampling-induced detail loss, while an inter-layer detail refinement fusion module (IDRFM) improves encoder–decoder feature alignment during reconstruction. Experiments on 2018DSB, ISIC2018, JSUAH-Cerebellum, and CVC-ClinicDB, covering nuclei segmentation in microscopy images, skin lesion segmentation in dermoscopic images, fetal cerebellum segmentation in ultrasound images, and polyp segmentation in colonoscopy images, demonstrate that DIG-MambaNet achieves consistent and competitive performance across diverse target structures and imaging conditions, with improved boundary delineation and favorable overlap-based accuracy compared with representative CNN-, Transformer-, and Mamba-based methods. Full article

Background/Objectives: Magnetotactic bacteria therapy is an emerging active intratumoral drug delivery platform in which drug-loaded, magnetically responsive bacteria are injected into a tumor and navigated through its microenvironment toward defined targets using an external magnetic field, fundamentally distinct from passive intratumoral injection. No endoscopic ultrasound (EUS)- or ultrasound (US)-guided delivery workflow for MTBT has been described, and five critical technical prerequisites for clinical translation remain unaddressed: three-body image registration, minimum contrast concentration for cone-beam computed tomography (CBCT) bolus localization, needle repositioning accuracy, optimal fiducial strategy, and EUS/US procedural feasibility within the magnetic guidance apparatus. Methods: In three healthy female swine, we tested an image-guided intratumoral workflow at pancreatic and rectal sites. Gold rod fiducials were implanted under EUS in two animals and via transabdominal/endorectal US in one animal. A needle was navigated toward the implanted fiducial group using real-time gold-fiducial shine-through, and 2 mL of saline mixed with iodine contrast (Isovue-370) at 15%, 10%, or 5% v/v (one concentration per animal) was injected. Scan with CBCT was acquired before and after injection; fiducials, needle tip, and contrast bolus were segmented in 3D Slicer and their centroids compared to quantify targeting accuracy. Contrast visibility and artifact were scored by an expert radiologist on a five-point Likert scale. EUS feasibility within the magnetic apparatus was assessed using a full-scale cardboard replica of the CuraDrone PolarTrak. Results: Five percent v/v Isovue-370 was the minimum concentration for reliable CBCT bolus identification (280–360 HU; 1:1 injection-to-volume ratio). Needle repositioning accuracy was ≤2 cm in 5/6 sites using fiducial shine-through guidance. Gold rod fiducials served a dual role: CBCT tumor registration and real-time EUS/US navigation, not previously described for intratumoral injection. EUS was feasible within the PolarTrak with defined workflow adaptations. Conclusions: This pilot study demonstrates the technical feasibility of an EUS/US–CBCT workflow for MTBT, yielding quantitative, actionable parameters for first-in-human trial design. These feasibility findings, obtained in a small healthy animal cohort, are intended to inform the design of subsequent clinical studies. Full article

Background/Objectives: This study aimed to compare the effects of platelet-rich plasma (PRP) versus corticosteroid injection administered after ultrasound-guided needling without lavage on pain, shoulder function, and radiographic resorption in rotator cuff calcific tendinitis. Methods: This retrospective single-centre cohort included 93 patients. All underwent ultrasound-guided needling of the calcific deposit without lavage. Treatment allocation reflected routine clinical practice and was non-randomised. Patients with Gartner type 1–2 calcifications received either PRP or corticosteroid injections, whereas type 3 patients were treated with needling + PRP or conservative management. Outcomes were VAS pain, Constant–Murley Score (CMS), QuickDASH, and radiographic resorption, assessed at baseline, 2 weeks, 6 months, and 12 months. Results: In Gartner type 1–2 disease, needling followed by PRP resulted in greater 12-month pain reduction than needling followed by corticosteroid (both p < 0.05), while improvements in CMS, QuickDASH, and 1-year complete resorption rates were similar between groups. Gartner type 3 calcifications showed substantial clinical improvement irrespective of treatment modality, but the combined needling + PRP intervention was associated with a higher rate of complete radiographic resorption at 2 weeks than conservative care (72.2% vs. 13.3%; p = 0.001). Four patients (4/93, 4.3%) required arthroscopic surgery (three corticosteroid, one PRP). Conclusions: In Gartner type 1–2 calcific tendinitis, ultrasound-guided needling followed by PRP was associated with greater 12-month pain reduction than needling followed by corticosteroid, whereas functional and 1-year radiographic outcomes were comparable. In symptomatic Gartner type 3 disease, the combined needling + PRP intervention was associated with faster early radiographic resorption but did not demonstrate superior long-term clinical outcomes; conservative treatment remains appropriate for patients with tolerable symptoms. Full article