Calcific tendinitis: Difference between revisions

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**Plain films will show calcification in the tendon(s) of the rotator cuff
**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)
**Note: calcification is not specific for calcific tendinitis (may occur in asymptomatic pts)
[[File:Calcific_Tendinitis.jpg‎]]


==Treatment==
==Treatment==

Revision as of 04:51, 22 February 2012

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)

Calcific Tendinitis.jpg

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

Source

  • Tintinalli