Calcific tendinitis: Difference between revisions

Revision as of 13:10, 9 August 2017

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

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)

Traumatic/Acute:

Nontraumatic/Chronic:

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

Authors:

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 ==Clinical Features==
-*"Calcification" phase
+*Precalcific phase
-**Patient may be asymptomatic or have mild pain at rest or at night
+**fibrocartilaginous metaplasia of the tendon
-*"Resorptive" phase (1-2wks)
+*pain-free
-**Sudden onset of severe pain, usually at rest, worse at night
+*Calcification phase
-**Any shoulder motion reproduces significant pain
+**Formative phase
-**TTP over proximal humerus near tendinous insertion of rotator cuff
+***characterized by cell-mediated calcific deposits
-*"Postcalcific" phase
+***+/- pain
+**resting phase
+***lacks inflammation or vascular infiltration
+**+/- pain
+**Resorptive phase (1-2 wks)
+***characterized by phagocytic resorption and vascular infiltration
+***most painful phase
+***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