Calcific Tendonitis
Calcific tendonitis of the shoulder is a condition in which calcium deposits form in the tendons of the rotator cuff muscles, causing pain and limited range of motion in the shoulder.
Anatomy:
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The rotator cuff is a group of muscles and tendons that attach the shoulder blade to the upper arm bone. These muscles and tendons work together to stabilize the shoulder joint and allow for movement.
Pathoanatomy:
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The exact cause of calcific tendonitis is not known, but it is thought to be related to changes in the blood supply to the tendons. This can lead to the deposition of calcium crystals in the tendons, which can cause inflammation and pain.
Mechanism of injury:
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Calcific tendonitis can occur spontaneously, or may be triggered by an injury or overuse of the shoulder. The condition is more common in people over the age of 40, and in those with certain medical conditions such as diabetes or thyroid disease.
Symptoms:
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The main symptom of calcific tendonitis is pain in the shoulder, which may be severe and may radiate down the arm. The pain may be worse at night or when lying on the affected shoulder. The condition can also cause limited range of motion in the shoulder, making it difficult to perform simple tasks such as reaching overhead or behind the back.
Phases of calcific tendonitis:
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Calcific tendonitis typically progresses through three phases:
1. Pre-calcification: Inflammation and swelling of the tendon, which may cause pain and limited range of motion.
2. Calcification: Calcium deposits form in the tendon, causing increased pain and stiffness.
3. Post-calcification: The calcium deposits begin to break down, causing inflammation and pain. This phase may last several months to a year.
Treatment options:
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Treatment for calcific tendonitis typically involves a combination of physical therapy, medication, and in some cases, surgery.
Non-operative management:
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Physical therapy is often the first line of treatment for calcific tendonitis. This may include exercises to improve range of motion and flexibility, as well as stretches to help relieve pain and stiffness. Anti-inflammatory medications such as ibuprofen or naproxen may also be prescribed to help reduce pain and inflammation.
Operative management:
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In cases where non-operative treatment is not effective, surgery may be necessary. This may involve arthroscopic surgery to remove the calcium deposits from the tendon, or open surgery to repair the tendon if it has been damaged.
Recovery time:
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Recovery time for calcific tendonitis can vary depending on the severity of the condition and the effectiveness of treatment. Mild cases may resolve in a few months with non-operative treatment, while more severe cases may take a year or more to fully resolve. Recovery time after surgery may also vary, but most patients can expect to regain significant range of motion within a few weeks to a few months.