Calcific Tendonitis of the Shoulder: Protector or Predictor of Cuff Pathology? A Magnetic Resonance Imaging–Based Study

Association Between Rotator Cuff Tears and Calcific Tendinopathy

“…The authors concluded that the incidence of cuff tears in patients with calcific tendonitis who underwent magnetic resonance imaging is higher than previously reported. 1 Cloudy-appearing calcified lesions showed an association with rotator cuff tears.…”

“…This last statement may be confirmed by earlier studies but also by the findings of the authors. 1,6,7 The objective of this letter is to formulate another "philosophy" as an explanation why calcific tendinopathy is a protector and also a predictor for a rotator cuff tear. The pathology can start with a calcific tendinopathy and may end with a full-thickness tear, this with phase of partial tears and resorbing cloudy-appearing calcifications in between.…”

Arthroscopic Excision of Infraspinatus Calcific Tendinitis With Double-Row Margin Convergence Repair

“…It commonly presents in patients aged 30 to 60 years and is bilateral in about 10% to 25% of the patients. 2 Regarding the localization of calcifications, most reports concur that the supraspinatus tendon is most commonly involved, with an incidence in 51.5% to 90% of the cases and with negligible rates for the other tendons. 3 Only one study reported a much greater involvement of the infraspinatus (about 50%) and subscapularis (33%) compared with previous studies.…”

“…4 Most of the calcifications are insertional, situated in the so-called "critical zone," resulting from its poor vascularization. 2,4 Controversy exists concerning the etiology and pathogenesis of this disabling ailment. 5 The main clinical feature of calcific tendinitis is shoulder pain; it may be associated with restriction of joint mobility.…”

“…Calcific tendonitis can be diagnosed by routine shoulder radiographs, ultrasonography, and/or magnetic resonance imaging. 2,5 Several treatments are currently in use, although the best choice remains controversial. There is, however, a fairly large consensus in starting with a conservative approach based on rest, nonsteroidal anti-inflammatory drugs, physical therapy, local corticosteroids subacromial injections, and/or extracorporeal shock wave therapy.…”