Frozen Shoulder and Rotator Cuff Tendinopathy Treated with TAME — Case Report

Ms. L, 57 years old, had right shoulder pain for over 3 years and was diagnosed with "rotator cuff tendinitis." Despite long-term use of painkillers and patches, and traditional treatments such as rehabilitation, the pain persisted, reaching a pain index of 8 (out of 10), to the point that even raising the arm was impossible, and lifting heavy objects was impossible.

After traditional treatments proved ineffective, the patient sought treatment at National Cheng Kung University Hospital Orthopedics. Because the patient was unwilling to undergo surgery, they were referred to the Interventional Medicine Center for further discussion.

After discussion, Bow Wang, M.D. ultimately chose to perform "transarterial embolization treatment" for Ms. K. Guided by X-ray fluoroscopy, under local anesthesia, a puncture was performed via the femoral artery in the groin (or radial artery).

A microcatheter was then inserted into the painful area of ​​the shoulder. Under arterial angiography, a contrast agent was injected to identify newly formed capillary-like vessels. Embolizing medication was then injected through the microcatheter to remove these abnormal capillary-like vessels.

After embolization, two weeks after the treatment, the pain index finally dropped from 8 points to 1 point. Now, he can raise his arm and even hold his grandson.

Two weeks post-embolization(Video recorded with patient consent)

Four months post-embolization(Video recorded with patient consent)

However, Bow Wang, M.D. reminds that the application of transarterial embolization for "frozen shoulder/rotator cuff tendinitis" has its limitations. The main indications are a pain index exceeding 5 points and no significant improvement after more than three months of various treatments.

　

This treatment is not suitable in the following situations:

1. Severe tendon or ligament damage or rupture

2. Pain accompanied by other nerve compression symptoms, such as numbness

3. Poor kidney function (eGFR < 30 mL/min/1.73m2)

4. Low platelet count, abnormal coagulation function

5. The patient is unable to lie flat for two hours

6. Pregnancy

Side effects of treatment include potential local hematoma and bruising at the puncture site; temporary local discoloration at the embolization site, which will improve and disappear within several days to a month.

It is recommended that patients undergo a detailed evaluation by a physician to confirm the true source of pain, and have a thorough discussion with their doctor and family to understand the treatment process and related precautions before receiving treatment for better assurance.