Calcific tendinopothy

Degenerative calcification is often seen on scans of the rotator cuff and part of degenerative tendinopathy of the tendons.

However 'calcific tendonitis' is a specific disease entity with a well described disease process.

Calcific tendonitis can present in different ways depending on the stage of the disease process, size and location of the calcific deposit. The common presentations are described below:

1. Subacromial impingement - due to cuff dysfunction from the clacification and the space occupying calcific deposit in the supra/infraspinatus tendons.
2. Persistent aching pain - due to the pressure effects of a large calcific deposit in the cuff.

Clinical signs will vary depending on the presentation:

1. Impingement signs (Neers, Hawkins, Copelands, empty can)
2. Impingement & cuff pain (Jobes, empty can / full can, cuff weakness)
3. Severe pain, joint tenderness and stiffness (similar to an acute painful frozen shoulder)

Diagnosis:

• Calcium may be seen on x-rays - ideally need 3 views - AP, Axillary & Outlet views
• Ultrasound scan - most useful, as allows 3 dimensional and dynamic assesment of the rotator cuff; also differentiates degenerative calcification from true calcific deposits.