Calcific tendinitis

In calcium hydroxyapatite crystal deposition disease the shoulder is the most common site of calcific deposits. Abnormal deposits occur particularly in the supraspinatus tendon but also in the other tendons of the rotator cuff, adjacent tendons and bursae. In the elbow, calcification affects the region adjacent to the medial and lateral humeral condyles, the area of the collateral ligaments, the insertion of the triceps tendon on the ulnar olecranon and the olecranon bursa. Calcified deposits in the wrist are observed in or near the tendons of the flexor carpi ulnaris, flexor carpi radialis, common flexor and extensor carpi ulnaris muscles. In the hand, the regions of the metacarpophalangeal joints and fingers are involved. Other sites of calcific tendinitis include the hip and pelvis, foot (including ankle and heel) and neck (longus colli muscle and tendon).

Calcification within tendons is better delineated with routine radiography, conventional tomography or CT scanning than with MR imaging. In addition, erosion of bone beneath calcified tendons is well shown by CT and MR imaging.

Numerous other conditions produce periarticular radiographic findings resembling those of calcific tendinitis, and in some cases (such as de Quervain's disease) tendinitis may cause soft tissue swelling without radiographically recognizable calcification.

DR