Calcific tendinitis and calcific bursitis

Case contributed by Dalia Ibrahim
Diagnosis almost certain

Presentation

Right shoulder pain.

Patient Data

Age: 45 years
Gender: Female
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Info

Calcification of the supra and infraspinatous tendon insertions (Calcific tendinitis. Calcification is also seen within the subdeltoid bursa showing fluid level (milk of calcium), representing subdeltoid bursitis.

Case Discussion

Calcific bursitis is the result of the deposition of calcium hydroxyapatite crystals. It is closely related to calcific tendinitis, and many authors refer to them as being the same condition. It may occur in isolation or in association with calcific tendinitis.

The calcium hydroxyapatite crystals erode into an adjacent bursa, typically triggering an intense inflammatory reaction that may lead to liquefaction (milk of calcium).

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