ABSTRACT
Calcific tendinitis is a clinical entity of unknown cause. Calcific deposits can occur in any tendon in the body, but most commonly it involves the shoulder. Clinically, calcific tendinitis presents as an acute or chronically painful condition that is caused by inflammation around calcific deposits located in or around the rotator cuff tendons. The process involves multifocal, cell-mediated calcification of a living tendon that is usually followed by spontaneous, phagocytic resorption (1). During the deposition of calcium, the patient may have only mild or moderate pain or may be completely asymptomatic. It is believed that the condition only becomes acutely painful once the calcific deposits start to undergo resorption. After resorption or surgical removal of deposits, the tendon reconstitutes itself (2). The diagnosis is made by careful history and physical examination, with careful analysis of radiographic evidence of calcification. Initial treatment is always conservative. Nonoperative interventions include rest, immobilization, heat and cold therapy, range of motion and pendulum exercises, oral nonsteroidal anti-inflammatory medications, and subacromial steroid injections. Localized disruption of the calcifications using a “needling” technique or an extracorporeal shock wave therapy has had some success. Failure of conservative measures may lead to the need for surgical excision of the lesion, which may be performed open or arthroscopically.
