Sonography in the Treatment of Calcific Tendinitis of the Rotator Cuff

Abstract

escribed as early as 1872, calcific tendinitis of the rotator cuff is a commonly diagnosed entity that may be responsible for considerable shoulder pain and limitation of motion in many patients. 1 By definition, this disease involves the deposition of calcium hydroxyapatite within the tendons of the rotator cuff. The entity is more common in women and is most often symptomatic in patients 40 to 60 years of age. The etiology of this condition is uncertain, with most theories suggesting that the calcium deposition occurs within an area of tendon degeneration or hypovascularity. Over the years, several therapies have been proposed as the optimal treatment for this condition. The ideal treatment technique for this or any other condition should meet several criteria. The procedure should be relatively comfortable for the patient, minimally invasive, and of as short a duration as possible. It should be cost-effective and safe, with a proven record of minimal complications. As the calcium deposition is the cause of the patient’s symptoms, a procedure that includes the effective removal of this calcification is ideal. Finally, a procedure that also addresses the patient’s pain during the ensuing weeks and months would be optimal. This article will discuss the vital importance of sonography in confirming the diagnosis of calcific tendinitis as well as in guiding the percutaneous lavage aspiration that should be the mainstay of therapy in this patient population.