CALCIFIC TENDONITIS

A Calcium Deposit Within the Rotator Cuff Tendon

(but probably not in this girl to the left)

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What is it?

Calcific tendonitis of the shoulder happens when a calcium (carbonate hydroxyapatite) deposit forms within one of the tendons of the rotator cuff.  The tendon tissue around the deposit can become inflamed, causing a great deal of shoulder pain.

Calcific Tendonitis of the rotator cuff

Why Did I Develop Calcific Tendonitis?

No one really knows what causes calcific tendonitis, but it does seem to be related to wear and tear.   As we use our shoulder, the fibers of the tendons begin to fray and tear, just like a worn-out rope, and calcium deposits form in the damaged tendons as part of the healing process.  Some researchers think that calcium deposits form because there is not enough oxygen to the tendon tissues.  Others feel that pressure on the tendons can damage them, causing calcium deposits to form.

How Do I Know if I Have it? 

An x-ray is usually required to confirm the presence of a calcific deposit in the rotator cuff.  An x-ray can also determine the exact location of the deposit.

Non-Surgical Treatment

First-line treatment involves rest and anti-inflammatory medications, such as ibuprofen.  If this does not work for you, or if your pain is severe, you may be offered an ultrasound-guided cortisone injection to ease inflammation and swelling.

Lavage Procedure

Another option is to remove the calcium by inserting a needle directly into the deposit and rinsing with sterile saline.  This procedure is called lavage and can be performed with an ultrasound machine in clinic.  Sometimes lavage breaks the calcium particles so they can be removed with the needle.  This can also help to speed up the healing process.

Surgery

If the pain worsens and conservative treatments have failed, you may need surgery.  Surgery for calcific tendonitis is performed with an arthroscopic procedure involving small incisions, and the entire calcium deposit is resected using small instruments.  The surgery is performed under general anesthesia, and patients can go home the same day.

Supporting Literature

(Click on the Journal Image for a Link to the Article)

Does adding platelet-rich plasma (PRP) at the time of surgery improve your chance of a good outcome?

No, it does not.  All patients in this study underwent surgical removal of the calcium deposit, and half of them received PRP at the time of surgery.  All patients improved after surgery, and there was no difference in outcome in the PRP group.

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