Calcific Tendinopathy

This article is still missing information.

Calcific tendinopathy is most commonly seen in the shoulder (but also in other tendons) and is characterised by the deposition of calcium hydroxyapatite crystals within a healthy tendon.

Pathophysiology

The calcification is different to that seen in degenerative tendinopathy. In degenerative tendinopathy there is a heterogenous mixture of calcium salts that are diffusely scattered throughout the tendon in an area of collagen degeneration or tearing.

In calcific tendinopathy on the other hand, the calcification forms focally in a 'critical zone' which is 1-2cm from the tendon insertion. This critical zone is thought to have high shear and stress forces that promote the development of a focal calcium deposit between healthy collagen fibres.

Locations

Calcific tendinopathy is most commonly seen in the supraspinatus tendon. Other tendons of the shoulder are less commonly affected. It can also be seen in multiple other different tendons in the body.

Epidemiology

Usually seen in patients in their 30s to 50s, and women are more commonly affected than men. This is in contrast to degenerative tendinopathy where patients are in their 50s to 60s.

It is associated with diabetes, hypothyroidism, and hyperlipidaemia.

Clinical Features

There are four pathological stages of the disease: formative, resting, resorptive, and reparative. Patients start with diffuse pain which progresses to focal pain and resolution.

Treatment

Treatment options include analgesia, corticosteroid injection, extracorporeal shockwave therapy, ultrasound guided percutaneous barbotage, and surgical debridement.

See Also

See open access review by Catapano an colleagues.

• Tendoninopathy
• Myotendinous Junction
• Enthesis
• Fibrous Connective Tissue