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Calcific Tendinitis

  • Simon Boyle
  • Geoffrey C. S. Smith
Chapter

Abstract

Calcific tendinitis is a commonly encountered but painful disorder presenting to general practitioners, musculoskeletal specialists and orthopaedic surgeons. It has a prevalence of 2.7–7.8% in shoulders and most frequently involves the supraspinatus tendon.

Its aetiology is considered to be either cell mediated or degenerative in nature and the pathology evolves in three phases. The most frequent clinical presentation is one of pain which tends to be at its most severe during the resorptive phase. The diagnosis of calcific tendinitis is based on clinical history and examination and is supplemented by plain x-rays.

Many patients may be managed symptomatically with NSAID’s and gentle physiotherapy as the natural history of a calcific deposit can be one of resolution and resorption over time. The painful phase can be eased with a subacromial injection of local anaesthetic and steroid.

When symptoms fail to resolve with more conservative means, ultrasound guided needle aspiration and barbotage or extracorporeal shock wave therapy offer safe and effective treatment options.

In more resistant cases, arthroscopic excision can result in up to 90% successful outcomes. Debate continues as to the need for routine repair the rotator cuff post excision of the calcific deposit and for the role of a supplemental a subacromial decompression.

Keywords

Calcific tendinitis Shoulder Pain Ultrasound Shock wave therapy Arthroscopy 

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Simon Boyle
    • 1
  • Geoffrey C. S. Smith
    • 2
  1. 1.York Teaching HospitalYorkUK
  2. 2.St George HospitalSydneyAustralia

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