Patients with calcific tendonitis compare the pain intensity to a kidney stone or acute gout attack. Lindsay Harris sheds some light on who is typically affected, how it is classified, and the treatment options available.
Australia’s Rinky Hijikata and Australia’s Max Purcell in action during their doubles final match against New Zealand’s Michael Venus and Britain’s Jamie Murray REUTERS/Androniki Christodoulou.
Calcific tendonitis of the shoulder is an acute or chronic painful condition due to the presence of calcific deposits inside or around the tendons of the rotator cuff. It is an enthesopathy, a self-limiting disease characterized by the deposition of calcium phosphate crystals in or around the rotator cuff tendons (see figure 1)(1). This calcium deposit is a paste-like material in or around the tendon and not a hard object that one would expect. An enthesopathy is a disease that affects places where tendons, ligaments, or muscles attach to bones.
Rotator cuff disease is a common cause of shoulder pain. Calcific tendonitis is one of many differential diagnoses of rotator cuff disease. In its acute presentation, patients typically respond to conservative treatment. While patients with chronic calcific tendonitis usually fail to respond to conservative treatment and often require surgery.
Among patients with calcific tendonitis, 2.7 – 20% are asymptomatic, and 35 – 45% of patients whose calcific deposits are discovered develop shoulder pain(1). It typically occurs between the ages of 30 and 50 and is rare in those older than 70. It is approximately twice as likely to occur in women as in men. It presents bilaterally in 10% of patients. Diabetes and gout are risk factors for calcific tendonitis. However, a comprehensive link is missing. Furthermore, there is no relation to injury, physical activity, diet, or osteoporosis.
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