Calcific tendinitis (ruptured)

Case contributed by Dr Bruno Di Muzio

Presentation

Excruciating right shoulder pain with associated local increased temperature. Has had corticosteroid injection done by the GP three days ago. Septic joint?

Patient Data

Age: 40 years
Gender: Female

Right shoulder radiographs

Globular calcification surrounding the greater tuberosity most likely represents calcium hydroxyapatite deposition within the supraspinatus tendon, with signs of rupture into the subacromial space or into the bursa. The glenohumeral joint is normally aligned with no erosive changes identified. The acromioclavicular joint is normal.

Ultrasound

Shoulder ultrasound

There is echogenic material within the supraspinatus tendon that appears to track down along the greater tuberosity, forming an extra tendinous pouch with compressible and mobile debris. Correlation with the radiographs, where it is shown to be dense, makes it highly concerning for a ruptured calcific bursitis. 

Case Discussion

This case illustrates classic appearances of calcific tendinitis involving the supraspinatus tendon with due to rupture of the calcium hydroxyapatite deposits into the subacromial space/bursa.

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Case information

rID: 56393
Case created: 30th Oct 2017
Last edited: 13th Nov 2017
Inclusion in quiz mode: Included

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