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
Source
- Tintinalli