Calcific tendinitis

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  • Self-limiting disorder of calcium deposition within one or more tendons of the rotator cuff
    • With time, the calcium undergoes painful resorption with subsequent tendon healing
  • Middle-aged patients are most commonly affected (rarely seen in patients >70yrs)
  • Adhesive capsulitis is most common complication

Clinical Features

  • "Calcification" phase
    • Patient may be asymptomatic or have mild pain at rest or at night
  • "Resorptive" phase (1-2wks)
    • Sudden onset of severe pain, usually at rest, worse at night
    • Any shoulder motion reproduces significant pain
    • TTP over proximal humerus near tendinous insertion of rotator cuff
  • "Postcalcific phase: variable levels of pain and shoulder dysfunction


Calcific tendinitis
  • Imaging
    • Plain films will show calcification in the tendon(s) of the rotator cuff
    • Note: calcification is not specific for calcific tendinitis (may occur in asymptomatic patients)

Differential Diagnosis

Shoulder and Upper Arm Diagnoses



Refered pain & non-orthopedic causes:


  • Nonoperative management is successful in 90% of cases
  • Analgesia
    • NSAIDs, opioids
  • Avoid immobilization
    • Rest shoulder in abduction on back of a chair as soon as tolerable
    • Sleep with pillow beneath axilla


  • Primary care referral within 1wk

See Also