Intramuscular migration of calcium hydroxyapatite crystal deposits involving the rotator cuff tendons of the shoulder: report of 11 patients

Intramuscular migration of calcific tendinopathy in the rotator cuff: ultrasound appearance and a review of the literature

“…However, Pereira et al suggest that MRI is the modality of choice to assess muscle involvement in calcific tendinopathy [9]. It is important to remark that intramuscular calcification may create an inflammatory response, with a diffuse muscular oedema involving the muscle of the rotator cuff: this appearance at MRI may be misleading: Mileto et al reported an intramuscular migration of calcium in the supraspinatus simulating a Parsonage-Turner syndrome.…”

“…In one, for persisting pain and functional limitation, the Orthopaedist chose to confirm the diagnosis and the extent of the calcification with MRI and to remove it by surgery. In Pereira's study, follow-up information was available in five subjects: two of which underwent arthroscopic surgery after the failure of conservative therapy [9]. Vinanti et al reported to have treated this disease surgically in one patient [11]; Wang et al treated one patient with an intramuscular calcification of the subscapularis through ultrasound guided needling [12].…”

“…Recently Pereira et al retrospectively reviewed the radiology report databases of three affiliated institutions for shoulder MRI examinations obtained over a 7-year period, founding eleven patients with a muscular migration of rotator cuff calcific tendinosis [9]. They hypothesize that the migration may be related to intrasubstance delaminating-type tendon tears that provide a pathway for the calcifications, although such tears in their series were not clearly visualized.…”

Ultrasound Appearance of the Migration of Tendon Calcifications

“…Intramuscular migration of CTe is a rare condition, mainly involving the rotator cuff (Figure ) . Pereira et al hypothesized that calcium deposits may migrate through delaminating intrasubstance tendon tears, although they could not demonstrate this.…”

“…Intramuscular migration of CTe is a rare condition, mainly involving the rotator cuff (Figure ) . Pereira et al hypothesized that calcium deposits may migrate through delaminating intrasubstance tendon tears, although they could not demonstrate this. Ultrasound can effectively depict the intramuscular migration of calcium deposits because the hyperechoic calcifications can be easily visualized surrounded by the hypoechoic muscle (Figure ) .…”