calcific tendonitis

Introduction

Also see supraspinatus tendonitis

Epidemiology

• generally develops after age 40

Pathology

• deposition of calcium salts, primarily hydroxyapatite, within a tendon
• may be initiated by ischemia or degeneration of tendon
• supraspinatus tendon is most frequently affected
  • it is frequently impinged upon
  • it has a reduced blood supply when the arm is abducted
• calcification within the tendon may evoke acute inflammation

Clinical manifestations

• chronic shoulder pain puctuated by acute attacks may occur secondary to inflammation
• may be asymptomatic
• range of motion may be limited by pain

Radiology

• X-ray of shoulder (calcific tenodonitis of the supraspinatus tendon)*
  • calcification in the subacromial space
  • calcification of the supraspinatus, generally near insertion on the humerus
  • small & scattered homogeneous, amorphous densities in soft tissue near the greater tuberosity of the humerus

Management

• non-steroidal anti-inflammatory drugs (NSAIDs)
• local glucocorticoid injections
• surgery in selected cases
• extracorporeal shock wave therapy
• ultrasound-guided lavage
  • of no benefit

More general terms

• tendonitis (tendon injury)
• ectopic/dystrophic calcification

Additional terms

• supraspinatus tendonitis
• tendon