Abstract
A 45-year-old woman presented to the emergency department with a 2-day history of severe left shoulder pain made worse with movement. Emergency department (ED) bedside point-of-care static and dynamic ultrasound examination of the supraspinatus tendon revealed supraspinatus tendon calcification with impingement syndrome, and the patient was urgently referred to orthopedics after ED pain control was achieved. Bedside shoulder and supraspinatus tendon evaluation with static and dynamic ultrasonography can assist in the rapid diagnosis of supraspinatus tendon calcification and supraspinatus tendon impingement syndrome in the emergency department.
Highlights
The prevalence of supraspinatus tendon calcification causing shoulder pain has been reported to be as high as 6.8%, mainly due to the supraspinatus tendon subacromial impingement syndrome with shoulder pain causing limited motion [1]
Radiology department diagnostic ultrasound evaluation of supraspinatus tendon calcification with subacromial impingement syndrome has been reported to be more specific (95% to 96%) than sensitive (71% to 81%) in adult patients, and supraspinatus tendon calcification with subacromial impingement syndrome diagnosed through ultrasonography has been reported in young athletes who perform overhead sports such as tennis, volleyball, and swimming [2-8]
Bigliani and Levine have classified the causes of subacromial impingement syndrome as either intrinsic/intratendinous or extrinsic/extratendinous, and each group can be either a primary etiology that directly causes the impingement or a secondary etiology which is the result of another process such as instability or neurologic injury [7]
Summary
The prevalence of supraspinatus tendon calcification causing shoulder pain has been reported to be as high as 6.8%, mainly due to the supraspinatus tendon subacromial impingement syndrome with shoulder pain causing limited motion [1]. Aside from the pain on her left shoulder, the patient reported no associated trauma, weakness, numbness, left upper-extremity tingling, shortness of breath, chest pain, or fever Her ED vital signs were as follows: temperature 36.9°C, blood pressure 132/70 mmHg, heart rate 73 bpm, respiratory rate 18 bpm, and oxygen saturation 98% on room air. With the patient in modified Crass position (where the patient placed her palm on her ipsilateral iliac wing and moved her elbow as posterior as possible), long-axis evaluation of the patient's supraspinatus tendon revealed calcification near the attachment to the greater tuberosity of the humerus, and a dynamic bedside ultrasound long-axis evaluation of the patient's supraspinatus tendon showed elevation of the greater tuberosity cranially to the level of the acromion and impingement of the supraspinatus tendon underneath the acromion of the scapula when the patient actively abducted her left humerus (Figures 1 and 2; Additional files 1 and 2). The patient's pain was controlled in the ED, and she was treated and released with oral pain medications, a left arm sling, and urgent orthopedic follow-up
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
