Calcific Tendonitis
Pathophysiology
Irritation of the tendons around the shoulder can lead to calcium deposits to form within the rotator cuff tendons. This can cause a build-up of pressure and chemical irritation which leads to pain. The calcium deposit can reduce the space between the rotator cuff and the bony process above, this is worse with overhead activities. Tends to be more common in those aged 30-60 years, it does disappear completely on its own but this can take several years to resolve.
Symptoms
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Generalised pain around the shoulder joint, often intense
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Pain may refer down the arm to the elbow
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Pain with overhead activities
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Pain at night, lying on sides may be worse
Management
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Activity modification
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Ice or heat
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Pain relief
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Physiotherapy
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Orthopaedic option of steroid injection, surgical removal or Barbotage to break up calcium deposits
Investigations
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X-ray can pick up calcium deposits as can ultrasound scans which make it easier to assess the size of the deposit in all directions.
