Calcific tendinitis in the shoulder occurs when a calcium deposit forms within one of the tendons in the shoulder. The calcium deposit can cause inflammation in the tendon. Calcific tendinitis can cause terrific shoulder pain which is very debilitating. The calcium deposit most often forms in the supraspinatus tendon and most commonly affects adults aged between 30-50 years.
The exact reason why a calcium deposit forms within a shoulder tendon is not yet known. Patients who are suffering from calcific tendinitis may complain of chronic pain in the shoulder or severe acute pain which is very debilitating. If the calcium deposit is large then this can cause mechanical symptoms whereby the deposit within the tendon causes impingement beneath the shoulder tip bone (acromion) when the arm is elevated to the side. This may cause the patient to complain of reduced range of movement in their shoulder due to the pain.
The above symptoms of calcific tendinitis can be similar to other causes of shoulder pain. The diagnosis is made by obtaining an x-ray of the shoulder which clearly shows the calcific deposit in the region of one of the shoulder tendons. (see picture)
Gradually with time the calcium deposit resorbs and dissolves away which alleviates the pain. However in some patients the deposit persists and causes prolonged symptoms that require treatment.
Treatment options include:
- Anti-inflammatory painkillers
- Ultrasound guided needle barbotage - an ultrasound machine is used to repeatedly insert a needle into the deposit to break it up and some saline is injected into the deposit to flush out some of the remaining calcium
- Arthroscopic excision of the deposit and subacromial decompression - this is a keyhole operation during which the calcium deposit is removed from the tendon and a subacromial decompression is performed which allows the tendon more room to move in which further reduces inflammation and pain.
For further details regarding this operation please see 'Arthroscopic Subacromial Decompression' in the operations section.
This is the procedure which is performed and at the same time the calcium deposit is removed from the affected tendon. It is very important that an up-to-date x-ray is obtained prior to surgery to ensure that the calcium deposit is still present in the tendon.