Relationship between calcific tendinopathy and rotator cuff tear on shoulder magnetic resonance imaging: case-controlled comparison

Abstract

Purpose: To determine the frequency of rotator cuff tear on the shoulder magnetic resonance imaging (MRI) of patients with rotator cuff calcific tendinopathy and the relationship between rotator cuff tear and calcific tendinopathy. Material and methods:In this retrospective case control study, 137 patients with calcific tendinopathy and 137 control group patients without calcific tendinopathy with shoulder pain, whose age, sex, and shoulder laterality values were matched, were compared in terms of rotator cuff tears on their shoulder MRI images. Results:The frequency of rotator cuff tear was found to be significantly higher in the control group (37.2%) compared to the calcific tendinopathy group (23.4%) (p < 0.01). Partial thickness was 81.3% in the calcific tendinopathy group and 70.6% in the control group, and no significant difference was observed between the two groups in terms of the size of the rotator cuff tear (p > 0.05). In the calcific tendinopathy group, there was no significant relationship between the localisation of calcification and the rotator cuff tear, and only in 4.4% of the participants were calcification and tear at the same location on the same tendon (p > 0.05, r = 0.04). Conclusions:The patients with calcific tendinopathy, who had been admitted with shoulder pain, did not demonstrate an increased risk of rotator cuff tear based on their MRI compared to patients with shoulder pain without calcific tendinopathy. No significant relationship was determined between calcific tendinopathy and rotator cuff tear.

Reliable diagnosis of posterosuperior rotator cuff tears requires a combination of clinical tests

“…More reliable clinical diagnosis of posterosuperior rotator cuff tears could reduce the reliance on magnetic resonance imaging or arthrography [35], which involve considerable costs and waiting times, especially in cases where symptoms may be triggered by a calcific tendinopathy [5, 49]. This is important to inform treatment options, which may include partial or complete repair, latissimus dorsi tendon transfer or reverse shoulder arthroplasty, considering patient expectations and tear patterns [6, 10, 12, 16, 30, 34, 40, 41].…”

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

“…Therefore, for all patients with shoulder pain, MRI evaluation is more objective and accurate for assessing the correlation between CaT and RCTs [ 12 ]. The signal intensity of calcification on MRI is low, and the accuracy of identifying calcification with MRI is about 95% [ 12 , 26 ]. In addition, the studies of Norenberg et al [ 27 ] show that compared with X-ray, MRI boasts a diagnostic sensitivity of 98% and a specificity of 96% for shoulder joint calcification.…”

Clinical Impairments and Rotator Cuff Tendon Pathology in Primary and Intrinsic Secondary Adhesive Capsulitis

“…Full-thickness rotator cuff tendon tears were confirmed when the injected contrast agent was leaked out from the glenohumeral joint into the subacromial subdeltoid bursa (SASD) on arthrography. [10][11][12] Partial-thickness tendon tears were diagnosed based on identification of focal nontransmural defects of fluid signal intensity in the rotator cuff tendon on proton-density or fat-saturated T2-weighted images on MRI, hypoechoic or anechoic defects that did not extend from the bursal to articular aspect of the tendon on ultrasonography, and absence of leakage of the contrast agent into the SASD bursa on arthrography. 10,11,13 Calcific tendinitis was diagnosed using radiograph and ultrasonography.…”

“…[10][11][12] Partial-thickness tendon tears were diagnosed based on identification of focal nontransmural defects of fluid signal intensity in the rotator cuff tendon on proton-density or fat-saturated T2-weighted images on MRI, hypoechoic or anechoic defects that did not extend from the bursal to articular aspect of the tendon on ultrasonography, and absence of leakage of the contrast agent into the SASD bursa on arthrography. 10,11,13 Calcific tendinitis was diagnosed using radiograph and ultrasonography. Calcification was visualized as a hyperdense mass of variable morphology and margins on radiograph.…”

“…Full-thickness rotator cuff tendon tears (FTTs) were diagnosed based on fluid signal intensity in the rotator cuff on fat-saturated T2-weighted images on MRI, and hypoechoic or anechoic defects indicative of communication between the bursal and articular surface with or without tendon retraction on ultrasonography. Full-thickness rotator cuff tendon tears were confirmed when the injected contrast agent was leaked out from the glenohumeral joint into the subacromial subdeltoid bursa (SASD) on arthrography 10–12 . Partial-thickness tendon tears were diagnosed based on identification of focal nontransmural defects of fluid signal intensity in the rotator cuff tendon on proton-density or fat-saturated T2-weighted images on MRI, hypoechoic or anechoic defects that did not extend from the bursal to articular aspect of the tendon on ultrasonography, and absence of leakage of the contrast agent into the SASD bursa on arthrography 10,11,13 .…”