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Calcific Tendonitis

Calcific tendonitis refers to a build-up of calcium in the rotator cuff (calcific deposit). When calcium builds up in the tendon, it can cause a build up of pressure in the tendon, as well causing a chemical irritation. This leads to pain. The pain can be extremely intense. It is one of the worst pains in the shoulder (the other being Frozen Shoulder ). 

In addition to the chemical irritation and presssure, the calcific (calcium) deposit reduces the space between the rotator cuff and the acromion, as well as affecting the normal function of the rotator cuff. This can lead to subacromial impingement between the acromion and the calcium deposit in the rotator cuff when lifting the arm overhead.

Calcific deposit in the rotator cuff of the shoulder

Calcific deposit on x-ray

Calcific deposit on ultrasound scan

Click Here for a video of a calcific deposit on Ultrasound Scan

Animation showing the correlation of the ultrasound and x-ray views:

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Treatment

Treatment of calcific tendinitis involves:

1.        Painkillers and anti-inflammatory medications

2.        Physiotherapy - keeps your shoulder strong and flexible and reduce the irritation

3.        Cortisone steroid injections - reduces inflammation and control the pain

4.   Ultrasound guided Barbotage    - under ultrasound guidance the calcific deposit is injected with a salt water solution and the calcium is also sucked out into a syringe. The area is then repeatedly washed.

5.    Surgical excision

Surgery for Calcific Tendonitis:

Surgery is required if the pain is not controlled with the methods above and/or the pain is extremely severe, with night pain.

The goal of any surgery to reduce the effects of impingement, by  increasing the amount of space between the acromion and the rotator cuff tendons, which will then allow for easier movement and less pain and inflammation. The calcium deposit is also debrided and released at the same time. The operation performed is Arthroscopic Subacromial Decompression & Excision of the Calcific Deposit .

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Patient Experience:

1. Chronic Shoulder - A Swannell

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