Calcific tendinitis

Calcific tendinitis (also calcific/calcifying/calcified/calcareous tenonitis/tendonitis/tendinopathy, tendinosis calcarea, hydroxyapatite deposition disease (HADD) and calcific periarthritis), a form of tendinitis, is a disorder characterized by deposits of hydroxyapatite (a crystalline calcium phosphate) in any tendon of the body, but most commonly in the tendons of the rotator cuff (shoulder), causing pain and inflammation.

The condition is related to and may cause frozen shoulder.

The etiology is unknown.

Presentation and diagnosis

Pain is often aggravated by elevation of the arm above shoulder level or by lying on the shoulder. Pain may awaken the patient from sleep. Other complaints may be stiffness, snapping, catching, or weakness of the shoulder.

The calcific deposits are visible on X-ray as discrete lumps or cloudy areas. The deposits look cloudy on X-ray if they are in the process of re-absorption, and this is also when they cause the most pain. The deposits are crystalline when in their resting phase and like toothpaste in the re-absorptive phase. However, poor correlation exists between the appearance of a calcific deposit on plain x-rays and its consistency on needling.

Treatment

Dietary calcium restriction

A controversial topic, this conservative treatment can be very effective for some patients, and reports of pain cessation with strict dietary calcium restriction have been documented. Dietary restriction...
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