Calcific tendinitis

Background

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

Clinical Features

• "Calcification" phase
  • Pt 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

Diagnosis

• 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 pts)

Treatment

• 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 w/ pillow beneath axilla

Disposition

• PMD referral within 1wk

See Also

• Shoulder Physical Exam Tests
• Biceps Tendinitis

Source

• Tintinalli