Calcific Tendinitis of the Rotator Cuff

Calcific tendinitis of the rotator cuff is a painful condition marked by the deposition of calcium crystals within the tendons of the rotator cuff. These deposits typically occur within the midsubstance of the cuff, 1–2 cm proximal to its insertion. The origin of calcific tendinitis remains controversial, but it is believed to result from a combination of factors, including mechanical stress on the rotator cuff tendons, microtrauma, and vascular changes. These factors can lead to the formation of calcium deposits within the tendons, which may gradually grow, causing inflammation and pain. Patients typically present with mild to severe shoulder pain. The pain is often described as sharp or stabbing and is usually located in the front or side of the shoulder. It may worsen with overhead activities or at night, leading to sleep disturbances. In some cases, patients may experience a limited range of motion and weakness in the affected shoulder. This condition can significantly impact an individual’s quality of life and their ability to perform daily activities, particularly those involving overhead arm movements. Timely diagnosis and appropriate treatment can lead to significant symptom relief and improved shoulder function. Diagnosing calcific tendinitis involves a combination of clinical evaluation and imaging studies. X-rays can reveal the characteristic calcium deposits within the rotator cuff tendons, which appear as dense, white areas. Ultrasound or magnetic resonance imaging may also be used to confirm the diagnosis and assess the extent of tendon involvement. The choice of treatment should be tailored to the individual patient’s needs and the severity of the condition. Early intervention and a multidisciplinary approach involving orthopedic specialists, physical therapists, and pain management specialists can optimize outcomes for individuals suffering from this condition. The management of calcific tendinitis can vary depending on the severity of symptoms and individual patient factors. Initial treatment often involves nonsurgical approaches such as rest, physical therapy, anti-inflammatory medications, and corticosteroid injections to alleviate pain and inflammation. Extracorporeal Shock Wave Therapy (ESWT) is another noninvasive procedure that uses shock waves to break up the calcium deposits within the tendon, promoting their resorption. In some cases, ultrasound-guided needle aspiration can be used to aspirate the calcium deposits, relieving pain and improving shoulder function. If conservative measures are unsuccessful, surgery may be considered. Surgical options include arthroscopic removal of calcium deposits and repair of any associated tendon damage. This chapter provides an overview of calcific tendinitis of the rotator cuff, covering its etiology, clinical presentation, diagnosis, and treatment options.