Abstract
Calcific tendonitis, or more appropriately tendinosis, of the rotator cuff is a relatively common cause of shoulder pain, which is usually self-limiting, but can be recurrent, progressive, and debilitating. Calcific deposits can develop in any rotator cuff tendon, but the vast majority occur in the supraspinatus tendon, followed by the infraspinatus and the subscapularis tendon. Calcific tendonitis is usually most symptomatic during the resorptive phase, during which there is an acute inflammatory reaction to the calcification. Radiographs of the shoulder are essential to confirm the diagnosis of calcific tendonitis, exclude other potential causes of shoulder pain, and allow planning for intervention. Conservative treatment, including nonsteroidal antiinflammatory drugs (NSAIDs), subacromial-subdeltoid (SASD) bursa corticosteroid injections, and physiotherapy, should be the first line of therapy for calcific tendonitis. When conservative treatment fails, ultrasound (US)-guided barbotage/lavage is a safe, quick, and effective way to provide immediate and long-term relief of symptoms. A SASD bursa corticosteroid injection should always be performed immediately following barbotage to prevent a calcific bursitis flare up due to some retrograde passage of calcium into the bursa during the procedure.
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