SCAPULOHUMERAL CALCAREOUS TENDINITIS

Pain guide

Calcareous tendinitis of the shoulder joint is an acute or chronic inflammatory disorder of the capsulo-tendinous cuff (especially the supraspinatus portion) characterized by deposits of calcium salts among tendon fibers. It is a common cause of acute pain near the lateral aspect of the shoulder joint in men over age 30. The calcium deposit may be restricted to the tendon substance or may rupture into the overlying bursa.

Symptoms consist of pain (at times severe), tenderness to pressure, and restriction of shoulder joint motion.

Radiographic examination confirms the diagnosis and demonstrates the site of the lesion.

Calcareous tendinitis must be differentiated from other cervicobrachial pain syndromes, pyogenic arthritis, osteoarthritis, gout, and tears of the rotator cuff.

The aim of treatment is to relieve pain and restore shoulder joint function. Pain is best treated by injection of the lesion with a local anesthetic with cortico-steroid. After treatment, early recovery of shoulder joint function should be fostered by supervised exercises. Acute symptoms occasionally subside after spontaneous rupture of the calcium deposit into the subacromial bursa. Chronic symptoms may be treated by analgesics, exercises, and injection of local anesthetics with corticosteroids. Rarely, calcine deposits may require surgical evacuation.

When x-ray examination shows that a deposit has disappeared, recurrence of that deposit is rare. Symptoms of periarthritis may persist if shoulder joint motion is not completely regained.

Pain guide