Calcific tendinitis

Revision as of 05:21, 18 February 2015 by Rossdonaldson1 (talk | contribs) (Rossdonaldson1 moved page Calcific Tendinitis to 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

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 pts)

Differential Diagnosis

Shoulder and Upper Arm Diagnoses

Traumatic/Acute:

Nontraumatic/Chronic:

Refered pain & non-orthopedic causes:

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

Source

  • Tintinalli