Abstract

ObjectiveThe present study was aimed at investigating bone involvement secondary to rotator cuff calcific tendonitis at ultrasonography.Materials and MethodsRetrospective study of a case series. The authors reviewed shoulder ultrasonography reports of 141 patients diagnosed with rotator cuff calcific tendonitis, collected from the computer-based data records of their institution over a four-year period. Imaging findings were retrospectively and consensually analyzed by two experienced musculoskeletal radiologists looking for bone involvement associated with calcific tendonitis. Only the cases confirmed by computed tomography were considered for descriptive analysis.ResultsSonographic findings of calcific tendinopathy with bone involvement were observed in 7/141 (~ 5%) patients (mean age, 50.9 years; age range, 42-58 years; 42% female). Cortical bone erosion adjacent to tendon calcification was the most common finding, observed in 7/7 cases. Signs of intraosseous migration were found in 3/7 cases, and subcortical cysts in 2/7 cases. The findings were confirmed by computed tomography. Calcifications associated with bone abnormalities showed no acoustic shadowing at ultrasonography, favoring the hypothesis of resorption phase of the disease.ConclusionPreliminary results of the present study suggest that ultrasonography can identify bone abnormalities secondary to rotator cuff calcific tendinopathy, particularly the presence of cortical bone erosion.

Highlights

  • Calcific tendinopathy is related to deposition of calcium hydroxyapatite in tendons

  • Signs of calcific tendinopathy with involvement of adjacent bone were identified by ultrasonography in 7/141 cases, with four being men and 3 being women, with ages ranging between 42–58 years

  • Intraosseous migration of calcium crystal deposits associated with calcific tendinopathy is well known in the literature[5,6,7,8,9]

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Summary

Introduction

Calcific tendinopathy is related to deposition of calcium hydroxyapatite in tendons. The origin of this micro crystal deposition disease remains obscure. Rotator cuff calcification occurs in approximately 2.5 to 7.5% of the shoulders in healthy patients[1]. Tendon calcifications are more commonly diagnosed by means of radiography, ultrasonography is a reliable technique in the detection and localization of rotator cuff calcifications[2,3]. Ultrasonography is useful to identify whether the tendon calcification is hard or soft[2,3].

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