MANUAL MINORS
Calcific tendinitis is a condition in which calcium deposits accumulate within the tendons of the rotator cuff, particularly in the supraspinatus tendon. This condition causes inflammation and pain in the shoulder, especially during movement. It is more common in middle-aged individuals and can present acutely or chronically. The exact cause is unclear but may be related to aging, repetitive shoulder use, and tendon degeneration.
Diagnosis
Diagnosis is based on shoulder pain that worsens with arm elevation or overhead movements. The pain can range from mild to severe and may radiate down the arm. Physical examination reveals tenderness over the affected area. X-rays are useful for visualising calcium deposits in the tendons, while ultrasound or magnetic resonance imaging (MRI) can help assess the extent of damage and inflammation.
Differential Diagnosis
Pathology | Characteristics |
|---|---|
Subacromial bursitis | Inflammation of the bursa without visible calcium deposits on imaging |
Rotator cuff tear | Significant pain and weakness, especially when raising the arm |
Bicipital tendinitis | Pain in the front of the shoulder, associated with arm flexion or supination |
Shoulder osteoarthritis | Chronic pain and stiffness, associated with degenerative changes visible on X-rays |
Emergency Management
Emergency management includes the use of non-steroidal anti-inflammatory drugs (NSAIDs) and analgesics to control pain. Ice application is recommended to reduce inflammation. In cases of severe pain, a corticosteroid injection into the subacromial bursa can provide rapid relief. Painful movements should be limited, and rest is advised during the acute phase.
Definitive Treatment
Definitive treatment depends on the severity of symptoms and the size of the calcium deposits. In most cases, conservative treatment with physiotherapy, stretching and strengthening exercises, and NSAIDs is effective.
Physiotherapy focuses on improving range of motion and strengthening shoulder muscles. If symptoms persist or the calcium deposits are large, treatments such as shockwave therapy to break up the deposits or ultrasound-guided percutaneous aspiration can be used.
In more severe cases, when conservative treatment is ineffective, arthroscopic surgery may be performed to remove the calcium deposits and repair any tendon damage. Postoperative rehabilitation is crucial for restoring full shoulder function and preventing recurrence.
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