In the context of calcific tendinitis, Ebenbichler et al. demonstrated short-term benefit with which therapy?

• A. Pulsed ultrasound
• B. Continuous ultrasound
• C. Transcutaneous electrical nerve stimulation
• D. Ultrasound with microbubbles

Answer: (A)

Pulsed ultrasound delivers energy in short bursts with a low duty cycle, producing non-thermal mechanical effects such as acoustic streaming and microcavitation. In calcific tendinopathy, these mechanical effects can help mobilize and partially resorb calcium deposits, while also improving local circulation and reducing inflammatory edema. Ebenbichler and colleagues found that this pulsed approach produced short-term improvements in pain and function, indicating a favorable early response. Continuous ultrasound (heat-focused) tends to rely more on thermal effects and may not promote deposit resorption as effectively in the short term. TENS provides analgesia but doesn’t address the calcium deposit itself, and ultrasound with microbubbles introduces a different cavitation mechanism not demonstrated by that study.