Calcific bursitis

Calcific bursitis of the shoulder

Inflammation of the bursa can lead to calcium deposition most commonly seen within the sub-acromial bursa of the shoulder.

 

calcific

Calcifying bursitis. (a) The image shows hyperechoic material within the subacromial subdeltoid bursa compatible with calcific deposits, most commonly calcium hydroxyapatite crystal, distension of the bursa (small arrows) by the extensive bursal calcification (b) Wide posterior acoustic shadow in calcific bursitis. The finding was correlated with shoulder radiography (not shown).

 

Subjective History

  • Often pain felt at the acromion
  • Pain may radiate to upper arm
  • Pain may be felt at rest and often worse at night
  • Patient may report a history of, gradual onset, repetitive upper limb activity; history of rotator cuff trauma
  • Often aggravated by shoulder abduction

Objective Examination

  • Positive painful arc – pain between 60 and 120 degrees
  • It is important to note that calcific  bursitis and a rotator cuff pathology can co-exist
  • Limited active range secondary to pain
  • Full passive range of motion 
  • Ultrasound/ X-ray or MRI can be used to confirm diagnosis

Treatment 

  • 0-48 hours NSAID’s, ice , rest
  • Physiotherapists may apply tape in the acute stage to help with a patients perception of pain and provide symptom relief
  • After 48 hours encourage active or active assisted shoulder range of movement within pain-free range
  • Once pain has subsided a rotator cuff strengthening programme can be implemented
  • For chronic persistent symptoms a corticosteroid injection under ultrasound guidance may be considered

 

References

  • Image from OpenI – Licensed by CC

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