Characterizing the Progression of Varying Types of Calcific Tendinitis around Hip

Abstract

PurposeTo assess the progression of clinical symptoms and disease course of calcific tendinitis in the hip region according to types of calcification.Materials and MethodsAmong patients with the hip pain, 28 patients (21 males and 7 females; mean age 51 years, range 32-74 years) showing calcified lesions in simple radiography without other possible sources of pain were analyzed retrospectively. Twelve patients displayed a symptom duration of less than three weeks (acute; average=1±0.9 week) and 16 displayed greater than three weeks (chronic; average=21.0±19.5 weeks). Lesions were classified as nodular (11, 39.3%), nodular-fragmented (13, 46.4%), or amorphous (4, 14.3%). Initial symptoms, progression of clinical features, radiological findings and prognosis were investigated and analyzed according to calcification type.ResultsIn 15 patients (53.6%), lesions were located superior to the great trochanter. On average, the acute group was younger (44.58 vs. 55.44 years, P=0.006), suffered more (mean pain Numeric Rating Scale [NRS], 6.3 vs. 3.8; P<0.001), and recovered more (difference between initial and follow-up NRS, 5.1 vs. 2.63; <<0.001) than the chronic group. The mean length of initial lesions was longer in the acute group than the chronic group (15.8 vs. 9.1 mm, P=0.008). When compared to patients with distinctive margins (15, 53.6%), those with nondistinctive margins showed better improvement (difference between initial and follow-up NRS, 4.7 vs. 2.8; P=0.01) and more significant decrease in lesion size (difference between initial and follow-up length, 10.8 vs. 2.6 mm; P=0.003).ConclusionCalcific tendinitis occurring in the hip area displayed a variety of characteristics. Although complaining of more severe pain in the initial phase, patients with acute pain or calcific lesions with nondistinctive margins showed better symptom improvement when compared to their counterparts.

A 57-Year-Old Woman with Calcific Tendinitis of the Gluteus Medius Presenting with Right Lateral Hip Pain Managed by Endoscopic Debridement

“…While it rarely occurs in the hip, the gluteus medius is one of the more commonly involved tendons [ 2 , 3 ] in such cases. Calcific tendinitis of the gluteus medius can present as either acute or chronic [ 7 , 11 ]. Patients who present acutely tend to experience significantly more pain, and the size of the calcifications on plain radiographs tend to be smaller [ 11 ].…”

“…Calcific tendinitis of the gluteus medius can present as either acute or chronic [ 7 , 11 ]. Patients who present acutely tend to experience significantly more pain, and the size of the calcifications on plain radiographs tend to be smaller [ 11 ].…”

Clinical Outcomes of Hip Arthroscopy for Hip Labrum Calcification in Young and Middle‐Aged Patients

“…Calcification disease is characterized by acute onset that is alleviated by conservative treatment and with symptoms recurring subsequently. Therefore, hip labrum calcification is often misdiagnosed as other diseases, such as synovitis, free body, infectious arthritis, tenosynovitis, and gouty arthritis 13 .…”

“…Calcification of the hip joint is mostly caused by tendon calcification, osteoarthritis of the hip joint, or postoperative heterotopic ossification, and it is mostly located in the greater trochanter, the gluteus medius, and the gluteus minor muscle. Calcification diseases that occur in the labrum of the hip joint are relatively rare 13 . As understanding of hip diseases deepens, calcification occurring in the labrum of the hip joint are occasionally reported and are typically referred to as labrum calcification deposition diseases.…”

Non-rotator cuff calcific tendinopathy: ultrasonographic diagnosis and treatment

“…Other rare sites are the piriformis (2 cases), the iliopsoas (2 cases), the ischiococcygeus (1 case) and the sartorius (1 case). Usually occurring in middle-age, patients have functional limitation, tenderness, pain and a positive Patrick's test [183]. Depending on the affected tendon, the differential diagnosis includes infection [124,180], arthritis, lumbar radiculopathy [126,140,168], os acetabuli, avulsion fracture, insertional calcified bursitis, sesamoid bones, myositis ossificans and chondrosarcoma [146].…”