Abstract
Calcific tendinitis is a condition characterised by the abnormal deposition of calcium hydroxyapatite crystals within the tendons of the rotator cuff. The characteristic appearance is that of acute or chronic shoulder pain combined with radiographic evidence of calcifications within the rotator cuff tendons. It is a specific disease entity which needs to be differentiated from other causes of rotator cuff calcium deposition. We present a case of calcific tendinitis with secondary erosion at the humeral insertion of the infraspinatus tendon. Conventional radiography proved unsuccessful in the initial diagnosis of the condition. Advanced modalities including both computed tomography (CT) and magnetic resonance imaging (MRI) proved to be both diagnostic and pivotal in the further management of the patient.
Highlights
The common clinical presentation of a painful shoulder paired with the radiological findings of rotator cuff calcifications will invariably lead to the inclusion of calcific tendonitis in the differential diagnosis
We present a case of calcific tendinitis with secondary erosion at the humeral insertion of the infraspinatus tendon
Intra-osseous calcific tendinitis localised to the infraspinatus tendon is an uncommon presentation of a common condition
Summary
The common clinical presentation of a painful shoulder paired with the radiological findings of rotator cuff calcifications will invariably lead to the inclusion of calcific tendonitis in the differential diagnosis. It is important to recognise that calcific tendonitis refers to a specific pathological entity which requires a definitive diagnosis in order to facilitate the appropriate treatment. Erosion and sclerosis of the humeral head at the site of the tendon insertion were demonstrated. Axial MRI PD FS images demonstrated heterogeneous signal changes within the distal infraspinatus tendon in keeping with calcifications and oedema. Low signal changes were visible in the humeral head, at the site of the infraspinatus tendon insertion, in keeping with erosion and sclerosis. The findings were in keeping with the diagnosis of calcific tendinopathy with intra-osseous extension (Figure 3)
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