Abstract

BackgroundCalcific tendinitis of the shoulder has a tendon involvement that could evolve to rotator cuff tear and shoulder osteoarthritis. This study aimed to evaluate the prevalence of glenohumeral osteoarthritis and rotator cuff tears in patients affected by calcific tendinitis at a minimum follow-up of 10 years after diagnosis.MethodsPatients diagnosed with calcific tendinitis of the shoulder with a minimum follow-up of 10 years were contacted and invited for a clinical and radiological evaluation. Information on the demographics, affected and dominant side, bilateral shoulder pain, type of treatment, habits, systemic or musculoskeletal diseases, reoperation of the index shoulder, and subjective satisfaction was collected. The clinical evaluation was performed using Constant–Murley score (CMS), American Shoulder and Elbow Surgeons Score (ASES), and numerical rating scale (NRS); isometric strength in forwarding flexion and abduction was also measured. Each patient also underwent an ultrasound examination to evaluate rotator cuff tendon integrity and a shoulder radiograph to evaluate osteoarthritis.ResultsSeventy-nine patients were available for a phone interview, and 35 agreed to be examined. The mean age was 58.89 (± 7.9) years at follow-up. The prevalence of glenohumeral osteoarthritis was 17.14% in the study population, with significant progression in 14.29% of the cases, without rotator cuff full-thickness tears. x-Ray examination showed residual calcifications in 31 patients, with a mean diameter of 5.54 mm. In 30 cases, there was a reduction of the diameter; in 4 cases, the calcification increased in size; and in 1 case, the size did not change. The mean ASES score was 74.1 (± 22.7) in the group with calcifications larger than 2 mm and 89.4 (± 8.2) in patients with smaller calcifications (p = 0.08) without correlation with the type of treatment performed.ConclusionsCalcific tendinitis is a self-resolving disease without rotator cuff tears at long-term follow-up or degenerative glenohumeral progression.Level of Evidence: 3, cohort study.

Highlights

  • Calcific tendinitis, described by Duplay in 1872, is a common cause of severe shoulder pain, especially in the middle-aged female population, with patients typically reporting a sudden atraumatic limitation of range of motion

  • Seventy-nine patients were available for a telephone interview, and 46 patients agreed to return to the hospital for clinical and radiological evaluation

  • The primary outcome of this study was the evaluation of the prevalence of glenohumeral osteoarthritis in patients affected by calcific tendinitis 10 years after diagnosis

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Summary

Introduction

Calcific tendinitis, described by Duplay in 1872, is a common cause of severe shoulder pain, especially in the middle-aged female population, with patients typically reporting a sudden atraumatic limitation of range of motion It is characterized by the presence of calcific deposits within the tendons of the rotator cuff and in the subacromial bursa, mainly consisting of calcium. According to Uhthoff [3], the pathology is due to low blood perfusion that leads to metaplastic transformation of tenocytes into chondrocytes (chondrocite-like cells) with the production and deposition of calcium hydroxyapatite. He proposed that the development of the pathology consisted of three phases: 1. This study aimed to evaluate the prevalence of glenohumeral osteoarthritis and rotator cuff tears in patients affected by calcific tendinitis at a minimum follow-up of 10 years after diagnosis

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