Case Of Acute Calcific Tendinitis Research Articles

급성 인두후 농양으로 오인된 경추부 장경근의 급성 석회화 건염 1예

급성 인두후 농양으로 오인된 경추부 장경근의 급성 석회화 건염 1예

Acute Calcific Tendinitis in the Distal Interphalangeal Joint.

Acute calcific tendinitis is a form of acute inflammation of the tendon, causing severe pain, swelling, and limited joint motion, and is characterized by radiologic evidence of periarticular calcification. The pathogenesis is not clear, but some believe that calcification may result from tendon hypoxia or a traumatic event [1]. Although it is a self-limited disease, in which periarticular calcification is eventually found to be resolved in radiologic imaging, it is often misdiagnosed, which can lead to unnecessary surgical intervention. It occurs most frequently in the shoulder and wrist, and least frequently in the hand, especially the phalanx [2,3,4]. We encountered a rare case of acute calcific tendinitis in a postmenopausal woman in the distal interphalangeal (DIP) joint and developed an appropriate management plan based on the correct diagnosis. A 72-year-old female patient visited the emergency department due to severe pain in the left fourth finger that had developed three days previously. Simple radiography and ultrasonography were first performed, along with routine laboratory examinations, including C-reactive protein levels. A careful history was taken and a physical examination was then performed with the presumptive diagnosis of acute calcific tendinitis or gout, based on radiographic findings. The patient showed redness, swelling, and local heat and tenderness of the radial side of the DIP joint of the left fourth finger, but denied any history of trauma or other inflammatory disease. The patient's history revealed that she used the DIP joint extensively because of her occupation (operating a mill). The initial radiographs showed an ovoid calcification on the radial collateral ligament of the DIP joint of the left fourth finger (Fig. 1), and ultrasonography revealed ovoid hyperechoic calcification (Fig. 2). Her C-reactive protein level was elevated. Based on previous studies of the treatment of acute calcific tendinitis of other regions, an anesthetic agent (2% lidocaine, Huons Co., Seongnam, Korea) and a corticosteroid (Triam, Shinpoong Co., Seoul, Korea) were locally injected into the lesion [3,4]. Nonsteroidal anti-inflammatory drugs (NSAIDs) were administered to the patient, and a short arm splint was applied for immobilization. One day after conservative treatment, the symptoms were dramatically alleviated and simple radiographic findings showed that the appearance of the calcification had become mottled (Fig. 3), and the patient's C-reactive protein level decreased gradually. After one week of treatment, the patient experienced a complete resolution of pain and exhibited a full range of motion without difficulty. Follow-up radiographic findings after two months showed spontaneous resolution of the calcification (Fig. 4) [5]. Fig. 1 The initial radiographs showed an ovoid calcification on the radial collateral ligament of the distal interphalangeal joint of the left fourth finger. Fig. 2 Ultrasonography revealed ovoid hyperechoic calcification. Fig. 3 One day after conservative treatment was initiated, simple radiographic findings showed a change from an ovoid calcification to a mottled appearance, which co-occurred with the dramatic alleviation of the symptoms. Fig. 4 Follow-up radiographic findings after two months showed the spontaneous resolution of the calcification. Acute calcific tendinitis of the DIP joint is a rare condition, and, to the best of our knowledge, has not previously been reported in this anatomical location. Careful attention to the history of the patient and simple radiography helped us to diagnose this case of acute calcific tendinitis correctly. Misdiagnosis of this disease can lead to unnecessary surgical treatment and delay symptom relief. Based on reports of this condition in other regions, such as the shoulder, elbow, and wrist, conservative management with NSAIDs and a local injection of an anesthetic agent and a corticosteroid were able to relieve the symptoms dramatically in our patient. In light of our experience, acute calcific tendinitis of the hand should be considered as part of the differential diagnosis of a painful finger joint.

A Case of Acute Calcific Tendinitis of the Hand: An Uncommon Condition that is Easily Overlooked and Misdiagnosed

Acute calcific tendinitis of the hand is uncommon, yet it has a high rate of misdiagnosis as it resembles other conditions such as fractures, inflammatory and infectious causes that give rise to pain and swelling in the hand. We present a case of acute calcific tendinitis in a middle age woman affecting the extensor pollicis longus to raise awareness of this uncommon, but easily treatable cause of pain and swelling. This case was first diagnosed as septic arthritis of the interphalangeal joint of the thumb. Correct diagnosis was made after careful review of history, physical examination findings, laboratory results and radiographs. (Hong Kong j. emerg.med. 2015;22:316-319)

A case of acute calcific tendinitis of the gluteus medius

A case of acute calcific tendinitis of the gluteus medius

Acute Calcific Tendinitis of the Flexor Digitorum Superficialis of the Finger: A Case Report

Acute calcific tendinitis of the shoulder is a well-known condition, but it is rare in the hand or finger. It is often misdiagnosed when it occurs outside the shoulder. We report an unusual case of acute calcific tendinitis of the flexor digitorum superficialis insertion of the 4th finger in a young female martial art athlete after minor trauma history, and discuss with a review of the literature.

Acute calcific tendinitis of the rectus femoris associated with intraosseous involvement: a case report with serial CT and MRI findings

Acute calcific tendinitis of the shoulder is a well-known condition, but it is rare in the rectus femoris origin. Mostly reported cases were occurred in the reflected head of the rectus femoris, and only few cases were in the direct head of the rectus femoris. Intraosseous marrow involvement of calcific tendinitis is a more rare condition; it often goes misdiagnosed as an infection or a neoplasm. We report a rare, unusual case of acute calcific tendinitis of the direct head of the rectus femoris associated with intraosseous marrow involvement of calcification in anterior inferior iliac spine with serial CT and MRI findings. Aggressive osseous change may occur in acute calcific tendinitis of the rectus femoris as in this case which should be made an appropriate diagnosis to avoid unnecessary investigation and overtreatment like a surgery.

Acute Calcific Tendinitis of the Flexor Carpi Ulnaris Causing Acute Compressive Neuropathy of the Ulnar Nerve: A Case Report

This study reports a case of acute calcific tendinitis of the flexor carpi ulnaris in a 64-year-old woman. She presented with symptoms of acute ulnar nerve compression mimicking a volar compartment syndrome. Owing to rapidly progressive symptoms, emergency surgical exploration was carried out. Intra-operatively a large mass of calcium phosphate carbonate was noted in association with the flexor carpi ulnaris near its insertion at the wrist compressing the ulnar nerve and artery in Guyon's canal. Postoperatively the patient had complete resolution of symptoms. Conservative management with non-steroidal anti-inflammatory drugs, rest, splinting, and steroid therapy is recommended for acute calcific tendinitis, but this case suggests a role for surgical treatment when there is acute neural compression and severe pain.

急性石灰沈着性頸長筋腱炎例

急性石灰沈着性頸長筋腱炎例

Acute calcific tendinitis of tibialis posterior tendon (TPT): A rare site of involvement

Calcific tendinitis is a benign inflammatory disorder characterised by deposition of calcium hydroxyapatite crystals in tendons and is commonly seen in tendons around shoulder joint but can also sometimes be encountered in other sites including the hip, wrist, elbow, hand, neck and foot. Calcific tendinitis can clinically mimic many other pathologic entities like infection, gout, myositis ossificans or avulsion fracture which frequently leads to misdiagnosis and inappropriate management. Imaging plays an important role in recognizing and evaluating calcific tendinitis and in differentiating this entity from other pathologic conditions. Calcific tendinitis is largely a self-limiting process which usually responds to conservative treatment although in refractory cases invasive options like steroid injection, needle aspiration or surgery can be considered. Early and accurate diagnosis can prevent needless tests and interventions which the patient may be subjected. We report a case of acute calcific tendinitis involving a rare site (tibialis posterior tendon) with its multimodality imaging appearance.

Calcific tendinitis of the gluteus maximus tendon with sciatic pain

A case of acute calcific tendinitis of gluteus maximus muscle is presented. The X-ray showed classical amorphous cluster of calfication at the lateral aspect of the proximal femur around the linea aspera. MRI findings included minor cortical erosion and diffused edema in the affected area. Local and radiating pain along the sciatic nerve was prominent in this case, which was unusual in gluteus maximus tendinitis.

Acute calcific tendinitis of the longus colli muscle: spectrum of CT appearances and anatomical correlation

Calcific tendinitis of the longus colli muscle is a retropharyngeal inflammatory process of the named prevertebral muscle that can present acutely with debilitating symptoms. The cross-sectional imaging appearances of this rare condition, although rather specific, can be somewhat misleading. This is, in part, due to a lack of familiarity with the normal anatomy and pathology of the prevertebral space, as well as the variation in the imaging appearances that can be found. Definitive radiological diagnosis is often paramount to avoid unnecessary and potentially dangerous intervention. Three cases of acute calcific tendinitis of the longus colli muscle are presented, with the salient anatomy and variation in CT appearances described.

An Unusual Presentation of Acute Calcific Tendinitis in the Hand

Acute calcific tendinitis (ACT) is a relatively uncommon disorder of the hand and wrist. ACT is a well-known condition of the shoulder, but it often goes unrecognized when occurring in the hand or wrist. The overall lack of familiarity along with the non-specific symptoms associated with ACT frequently leads to misdiagnosis or delay in diagnosis. We report a case of acute calcific tendinitis occurring in the carpal tunnel which is a rare presentation.

Acute calcific tendinitis of the thumb in a child: a case report

Acute calcific tendinitis is rare in hand and digit, especially in children. We describe a rare case of acute calcific tendinitis of the thumb [extensor pollicis longus (EPL) tendon] in a 10-year-old boy. Plain radiographs showed a calcium deposit in the EPL tendon. Conservative therapy completely resolved all symptoms in 1 week. The calcium deposit shown on plain radiographs became smaller and completely disappeared within 6 weeks.

Acute calcific tendinitis of the popliteus tendon--an unusual site and clinical syndrome.

Three cases of acute calcific tendinitis of the popliteus tendon presenting in the accident and emergency department as 'locked knee' are described. All patients presented with acute pain, flexion deformity and marked limitation of movements of the knee. All patients were unable to weight-bear on the affected side. The radiographs revealed well circumscribed calcification in two patients and faint stippled calcification in the third. All patients were referred to the next fracture clinic with a diagnosis of a mechanical problem within the knee joint due either to a 'loose body' or a meniscal tear. All patients responded to an injection of corticosteroids and local anaesthetic with immediate pain relief and lasting resolution of symptoms.

Acute calcific tendinitis in a child: A case report

Acute calcific tendinitis is an uncommon condition in which soft tissue calcification is associated with an acute inflammatory reaction that may be confused with an infection. Cohen 1 first described a case of acute calcium deposition at the insertion of the flexor carpi ulnaris in 1924. The condition usually occurs in the adult shoulder, wrist, hand, and, on rare occasions, lower extremity. To our knowledge, there is only one reported case of acute calcific tendinitis in a child. 2 This entity is so rare in children that it may not be considered when one is evaluating a child with a suspected infection.

Acute calcific tendinitis in the hand and wrist

Three cases of acute calcific tendinitis in the hand and wrist are described. The frequent misdiagnosis of this condition is discussed in the light of these cases and a review of the literature.

Computed tomography of acute cervical spine tendinitis

The authors present the first case of acute calcific tendinitis of the neck seen on computed tomography. Although clinical presentation and routine radiographs suggested the diagnosis, computed tomography established it by illustrating calcification of the longus colli muscle that was not seen on the radiographs. The illustrations and interesting aspects of the case are described.