Non-rotator cuff calcific tendinopathy: ultrasonographic diagnosis and treatment

Abstract

Calcific tendinopathy is a condition that is related to the deposition of calcium, mostly hydroxyapatite crystals, within the tendons. The shoulder and the hip are commonly affected joints, but calcific tendinopathy may occur in any tendon of the body. While there is an extensive literature on the ultrasound diagnosis of calcific tendinopathy of the shoulder, there are only sporadic reports on other sites. This review combines the experience of our centers and a thorough analysis of the literature from the last 45 years in order to highlight the localizations beyond the rotator cuff, their ultrasound characteristics and therapeutic possibilities.

Magnetic resonance imaging evaluation of the correlation between calcific tendinitis and rotator cuff injury

“…Clinically, CaT mainly occurs in patients aged 30–60 years [ 23 ]. However, as patients age, the incidence of degenerative RCTs increases, too [ 24 ]. CaT can be observed, not only in the supraspinatus and subscapular tendon within the “avascular critical zone,” but also in the subscapularis and teres minor tendon outside the “avascular critical zone” [ 21 ].…”

Imaging of calcific tendinopathy in atypical sites by ultrasound and conventional radiography: A pictorial essay

“…Two cases of CT of the common extensor tendon have been described in literature (fig 4) [14] and one concerning the triceps brachii tendon, treated with percutaneous US-guided therapy (fig 5 -7) [15]. In hand and wrist, the prevalence is about 2% where the flexor carpi ulnaris tendon, extensor carpi ulnaris tendon and the flexors and extensors of the fingers are the most affected locations [16].…”

“…After shoulder, the hip is the second most common site of CT [14]. The tendons of the quadriceps femoris are the most involved, in particular the vastus lateralis tendon at its origin and the rectus femoris adjacent to its insertion on the superior acetabular lip.…”

“…It is important to distinguish CT from calcific insertional tendinopathy, which manifests itself as a bone spur on the upper portion of the calcaneus and represents a distinct pathological entity, affecting mainly young athletes and older overweight subjects. Rarely the peroneus longus tendon is involved [14].…”

Ultrasound imaging of bone fractures

“…For instance, in non-displaced torus forearm fractures (i.e., Buckle fractures) and “greenstick” fractures, it has been shown that US is comparable to XR for both diagnosis and management [ 4 , 5 ]; moreover, several authors have demonstrated the pivotal role of US in the diagnosis of costal cartilage injuries in the pediatric population [ 2 , 6 , 7 ]. US is already widely used in musculoskeletal imaging for the assessment of superficial soft tissue illnesses [ 8 , 9 ], articular and periarticular pathologies [ 10 ], muscle disorders [ 11 , 12 ], nerve injuries [ 13 ], and tendinopathies [ 14 ].…”