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Review
. 2018 Jan 19;89(1-S):186-196.
doi: 10.23750/abm.v89i1-S.7022.

Rotator cuff calcific tendinopathy: from diagnosis to treatment

Vito Chianca  1 , Domenico Albano, Carmelo Messina, Federico Midiri, Giovanni Mauri, Alberto Aliprandi, Michele Catapano, Lorenzo Carlo Pescatori, Cristian Giuseppe Monaco, Salvatore Gitto, Anna Pisani Mainini, Angelo Corazza, Santi Rapisarda, Grazia Pozzi, Antonio Barile, Carlo Masciocchi, Luca Maria Sconfienza
Affiliations
Review

Rotator cuff calcific tendinopathy: from diagnosis to treatment

Vito Chianca et al. Acta Biomed. .

Abstract

Rotator cuff calcific tendinopathy (RCCT) is a very common condition caused by the presence of calcific deposits in the rotator cuff (RC) or in the subacromial-subdeltoid (SASD) bursa when calcification spreads around the tendons. The pathogenetic mechanism of RCCT is still unclear. It seems to be related to cell-mediated disease in which metaplastic transformation of tenocytes into chondrocytes induces calcification inside the tendon of the RC. RCCT is a frequent finding in the RC that may cause significant shoulder pain and disability. It can be easily diagnosed with imaging studies as conventional radiography (CR) or ultrasound (US). Conservative management of RCCT usually involves rest, physical therapy, and oral NSAIDs administration. Imaging-guided treatments are currently considered minimally-invasive, yet effective methods to treat RCCT with about 80% success rate. Surgery remains the most invasive treatment option in chronic cases that fail to improve with other less invasive approaches.

Keywords: calcific tendinopathy, rotator cuff, US, MRI, percutaneous treatments.

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Figures

Figure 1.
Figure 1.
Calcific tendinopathy (arrow) of the supraspinatus tendon evaluated using (a) conventional radiography and (b) ultrasound in the same patient. The calcification has a maximum diameter of 7 mm. H=humerus
Figure 2.
Figure 2.
Calcific tendinopathy of the supraspinatus (arrow). In this case, most of the calcification has drained into the subacromial-subdeltoid bursa (arrowheads), which can be easily seen on conventional radiograph. H=humerus
Figure 3.
Figure 3.
End of ultrasound-guided percutaneous irrigation of calcific tendinopathy procedure performed with (a) one needle (arrow) and (b) two needles (superficial needle, curved arrows; deeper needle, arrowheads). The calcification is totally empty (asterisks) in both cases. H=humerus
See this image and copyright information in PMC

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