Changing appearance of intraosseous calcific tendinitis in the shoulder with time: A case report

Hutchinson, Jeffrey Lawrence; Gusberti, Daniel; Saab, George

doi:10.1016/j.radcr.2019.07.021

Cited by 12 publications

(11 citation statements)

References 16 publications

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“…[ 9 ] The aetiopathogenesis of the disease is yet to be fully understood even though different theories have been suggested. [ 9 , 10 ] Treatment of this disorder usually involves physiotherapy and anti-inflammatory medications. [ 11 ] Nevertheless, the treatment options have not been proven to be satisfactory enough [ 5 ] even though several cases are believed to resolve spontaneously .…”

Section: Introductionmentioning

confidence: 99%

Interactive associations of sex and hyperlipidemia with calcific tendinitis of the shoulder in Taiwanese adults

Cai

Nfor

et al. 2020

Medicine

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Calcific tendinitis (CT) of the shoulder is a painful disorder usually identified in individuals aged 40 and 60 years. The estimated global prevalence of CT is 2.7% to 36%. We examined the association of hyperlipidemia and sex with CT of the shoulder using Taiwan Biobank (TWB) and the National Health Insurance Research Database (NHIRD). Data were available for 9903 TWB participants who were recruited between 2008 and 2015. We used multiple logistic regression analysis to estimate the odds ratios (OR) and 95% confidence intervals (CI) for CT of the shoulder. Overall, 1564 women, and 1491 men were identified with hyperlipidemia. Women, compared to men, had higher odds of CT of the shoulder (OR, 1.53; 95% CI, 1.08–2.16). Hyperlipidemia, compared to no hyperlipidemia, was associated with an increased risk of CT (OR, 1.40; 95% CI, 1.02–1.93). The test for interaction was significant for sex and hyperlipidemia ( P = .006). After stratification, the odds ratio for CT was 1.95 (95% CI, 1.30–2.92) in women and 0.82 (95% CI, 0.48–1.39) in men, respectively. Compared to men with no hyperlipidemia, the odds ratio was 0.86 (95% CI, 0.53–1.38) for men with hyperlipidemia and 2.00 (95% CI, 1.29–3.10) for women with hyperlipidemia. Importantly, our findings indicated that the risk for CT of the shoulder was higher among Taiwanese women with hyperlipidemia. However, CT risk among their male counterparts with hyperlipidemia was not significant.

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Section: Introductionmentioning

confidence: 99%

Interactive associations of sex and hyperlipidemia with calcific tendinitis of the shoulder in Taiwanese adults

Cai

Nfor

et al. 2020

Medicine

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“…In the acute phase, RCCT can present with intraosseous migration of calcific deposits, which induces osseous changes with aggressive features, such as cortical erosion, periosteal reaction, subcortical calcium migration, intramedullary edema, and clearly presence of soft tissue calcification [34,38]. Intraosseous penetration of calcium from RCCT has been reported in literature by small case series [34,[38][39][40][41]. Some of these studies described atypical findings that can mimic malignancy at CR.…”

Section: Common Evolution Of the Diseasementioning

confidence: 99%

“…Some of these studies described atypical findings that can mimic malignancy at CR. Usually, it presents as a single sclerotic lesion with radiolucent halo in the humeral head or well-circumscribed sclerosis at the greater tuberosity, associated with cortical erosion and narrow zone of transition [ 40 , 41 ]. In these cases, it should be considered different diagnostic hypothesis as bone island, osteoid osteoma, infection, and osteoblastic metastases [ 42 ].…”

Section: Usual Imaging Findings Of Rcctmentioning

confidence: 99%

“…In these cases, it should be considered different diagnostic hypothesis as bone island, osteoid osteoma, infection, and osteoblastic metastases [ 42 ]. MR can show an extensive pattern of edema in the perilesional bone marrow mimicking malignancy or extraosseous signal abnormality as focal rim of T1-hypointensity and T2-hyperintensity mimicking infection [ 40 , 41 ]. Sometimes MR can detect acute tendinopathy or subtle multifocal intrinsic low signal corresponding to the microcalcific deposits that can be helpful in the correct interpretation of images [ 40 ].…”

Section: Usual Imaging Findings Of Rcctmentioning

confidence: 99%

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Imaging of calcific tendinopathy around the shoulder: usual and unusual presentations and common pitfalls

et al. 2020

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Rotator cuff calcific tendinopathy (RCCT) is a very common condition, characterized by calcium deposition over fibrocartilaginous metaplasia of tenocytes, mainly occurring in the supraspinatus tendon. RCCT has a typical imaging presentation: in most cases, calcific deposits appear as a dense opacity around the humeral head on conventional radiography, as hyperechoic foci with or without acoustic shadow at ultrasound and as a signal void at magnetic resonance imaging. However, radiologists have to keep in mind the possible unusual presentations of RCCT and the key imaging features to correctly differentiate RCCT from other RC conditions, such as calcific enthesopathy or RC tears. Other presentations of RCCT to be considered are intrabursal, intraosseous, and intramuscular migration of calcific deposits that may mimic infectious processes or malignancies. While intrabursal and intraosseous migration are quite common, intramuscular migration is an unusual evolution of RCCT. It is important also to know atypical regions affected by calcific tendinopathy as biceps brachii, pectoralis major, and deltoid tendons. Unusual presentations of RCCT may lead to diagnostic challenge and mistakes. The aim of this review is to illustrate the usual and unusual imaging findings of RCCT that radiologists should know to reach the correct diagnosis and to exclude other entities with the purpose of preventing further unnecessary imaging examinations or interventional procedures.

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“…Some treatments including rehabilitation training, physical therapy, nonsteroidal anti-inflammatory drugs and even local injection treatment are available according to the disease severity[ 3 - 5 ]. After treatment, the symptoms of supraspinatus tendinitis are usually relieved, but its recurrence is common, which affects the patient’s life quality and leads to calcium or other pathological changes[ 6 ]. One of the main reasons for the high probability of recurrence is the lack of objective curative measures[ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Role of shear wave elastography in the evaluation of the treatment and prognosis of supraspinatus tendinitis

Zhou¹,

Yang²,

Wang³

et al. 2020

WJCC

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BACKGROUND Supraspinatus tendinitis recurs easily after treatment. One of the main reasons is the lack of objective tools for the efficacy evaluation. Shear wave elastography (SWE) can quantitatively analyze the tissue elasticity of region of interest by measuring the Young’s modulus (YM) value. AIM To explore the role of SWE in the efficacy and prognostic evaluation of supraspinatus tendinitis. METHODS Eighty-seven patients with supraspinatus tendinitis treated in Jiading District Central Hospital Affiliated Shanghai University of Medicine and Health Sciences were recruited. Another 30 healthy volunteers were enrolled as the control group. The visual analogue scale (VAS) and Constant-Murley Score (CMS) were recorded before treatment. All participants were scanned by SWE scan, and the YM value of the region of interest were recorded. Spearman correlation analysis was performed on YM values with VAS and CMS. Univariate repeated measures analysis of variance was used to calculate the changing trend of VAS, CMS and SWE under different treatment courses. After treatment, the patients were further grouped based on who achieved significantly effective and curative treatment. The patients in the continued treatment group continued to receive treatment according to the YM value, and the remaining patients who stopped receiving treatment were included in the stopped treatment group. All patients were followed up for 1 year, and the difference in recurrence rates between the continued treatment group and the stopped treatment group were compared. RESULTS The SWE images of supraspinatus muscle in healthy volunteers were mainly blue, while those of patients with supraspinatus tendinitis showed regional red and green areas. The average YM value of the supraspinatus muscle in healthy volunteers was 26.12 ± 4.03 kPa. The average YM value of patients with supraspinatus muscle was greater than that of healthy volunteers (average YM = 60.61 ± 11.53 kPa, t = 26.344, P < 0.001). The YM value was positively correlated with VAS ( r = 0.564, P < 0.001) and negatively correlated with CMS ( r = -0.411, P < 0.001). The changes of VAS and CMS were the most obvious in course 1 and then decreased gradually. The degree of change in YM values was similar in different courses. After a 1-year follow-up, the cumulative relapse-free rate in the continued treatment group was 91.43%, which was significantly higher than that in the stopped treatment group (64.71%, X 2 = 7.379, P = 0.007). CONCLUSION SWE can objectively indicate the severity of supraspinatus tendinitis. Using the YM value as a criterion for curative effect may reduce the recurrence rate.

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Changing appearance of intraosseous calcific tendinitis in the shoulder with time: A case report

Cited by 12 publications

References 16 publications

Interactive associations of sex and hyperlipidemia with calcific tendinitis of the shoulder in Taiwanese adults

Interactive associations of sex and hyperlipidemia with calcific tendinitis of the shoulder in Taiwanese adults

Imaging of calcific tendinopathy around the shoulder: usual and unusual presentations and common pitfalls

Role of shear wave elastography in the evaluation of the treatment and prognosis of supraspinatus tendinitis

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