Calcific tendonitis - subscapularis

Case contributed by Dr Vinay V Belaval


Pain and restricted movements of right shoulder since 1 week

Patient Data

Age: 60 years
Gender: Female

Axial and coronal T2w and axial PD fat-saturated images show diffuse thickening and edema of the subscapularis tendon. There are foci of hypointense signals in all sequences within the thickened tendon, representing calcifications. 

These features are consistent with calcific tendonitis of subscapularis.

Limited CT sections of right shoulder showed deposition of varying density calcium in the subscapularis tendon, consistent with MRI findings of calcific tendonitis.

Case Discussion

60 year old female presented with a 1-week history of pain and restricted movements of the right shoulder. MRI of right shoulder joint was requested with suspicion of rotator cuff tear. 

MRI showed thickened and edematous subscapularis tendon with amorphous intratendinous calcification, consistent with calcific tendonitis. Limited CT sections confirmed the calcific deposits. The calcific deposits showed varying densities. No extratendinous extension of the calcification noted.

Calcific tendonitis of rotator cuff muscles most commonly affects supraspinatus tendon followed by infraspinatus and subscapularis tendons. 

Calcific deposits can extend into adjacent bursae and soft tissues causing bursal or periarticular inflammation.  

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