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Calcific Tendinitis
Calcific tendinitis is a painful shoulder condition caused by a build-up of calcium within one of the rotator cuff tendons around the shoulder. The deposit may be small or large, and it is often clearly visible on a plain X-ray. An ultrasound scan is also very useful, as it helps confirm the diagnosis and shows the exact size and position of the deposit within the tendon.
The calcium deposit can increase pressure within the tendon and cause chemical irritation and inflammation. This may lead to significant pain, stiffness and reduced movement. In some patients, it can also reduce the space beneath the acromion and contribute to subacromial pain.
The symptoms are often very similar to those of subacromial shoulder pain syndrome. Patients commonly notice pain over the top and outer side of the shoulder, pain when lifting the arm, weakness, stiffness and difficulty sleeping on the affected side. At times, the pain can be extremely severe, with a marked loss of shoulder function.
Diagnosis
Diagnosis is based on the patient’s history and the clinical examination of the shoulder, supported by imaging investigations. A shoulder X-ray will often show the calcium deposit clearly. An ultrasound scan is particularly helpful because it confirms the size and exact position of the deposit and allows assessment of the rotator cuff tendon at the same time.
Treatment
Treatment usually starts with non-operative measures. These may include painkillers, anti-inflammatory medication, activity modification, physiotherapy and, in selected cases, a steroid injection to reduce inflammation and pain.
A commonly used minimally invasive treatment is ultrasound-guided barbotage. This is a procedure performed under ultrasound guidance, where a needle is inserted into the calcium deposit so that it can be broken up, washed out and partially or completely aspirated. A steroid injection may also be given at the same sitting.
If the symptoms remain severe or persistent despite appropriate non-operative treatment, arthroscopic surgery is an effective option. This is performed as keyhole surgery and may involve arthroscopic excision of the calcium deposit and/or arthroscopic subacromial decompression, depending on the findings and the degree of mechanical impingement. The aim is to remove the deposit, reduce pain and improve shoulder function.
These procedures are commonly performed as day-case surgery. Recovery is usually quicker than with open surgery, although rehabilitation and physiotherapy remain important parts of the recovery process. Further detailed information would be provided during consultation with Mr. Khalid Ayoub. Back...
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