Diagnosis and treatment of calcific tendinitis of the shoulder

As detailed in a publication within the Clinics in Shoulder and Elbow journal, calcific tendinitis of the shoulder, classified as an enthesopathy, is a condition that resolves on its own and is characterized by the accumulation of calcium phosphate crystals within the tendons of the rotator cuff. Typically, this condition presents most frequently in individuals aged between 30 and 50, with a lower incidence in those over 70 years of age. Interestingly, it is approximately twice as prevalent in women compared to men.
The causative factors behind calcific tendinitis of the shoulder remain the subject of debate, with two prevailing theories: degenerative calcification and reactive calcification. Over time, calcific tendinitis progresses to bursitis and inflammatory synovitis due to the chemical irritation caused by the calcium deposits. This thickening of the bursa can lead to collisions in the subacromial space, culminating in various forms of shoulder pain. Clinically, calcific tendinitis is classified based on symptom duration as acute (within 2 weeks), subacute (3 to 8 weeks), or chronic (lasting more than 3 weeks). Simple radiographic imaging of the shoulder can help identify the location of calcific deposits and predict the likelihood of collision-related symptoms. Ultrasonography is another useful diagnostic tool in this context.
The primary approach to managing calcific tendinitis is conservative, with a success rate ranging from 30% to 80%. Acute pain can be alleviated using non-steroidal anti-inflammatory analgesics, and it is advisable to rest the affected shoulder by employing an arm sling. Extracorporeal shock wave therapy (ESWT) is a broadly applied and particularly powerful remedy for ache relief. For further details on surgical treatment options, you can refer to the provided link for additional information.