scholarly journals Role of Radiographs and Ultrasound in Diagnosing Calcific Tendinitis and Periarthritis in the Wrist and Hand with Ultrasound-Guided Barbotage as Management Tool

Author(s):  
Ankita Ahuja ◽  
Malini Lawande ◽  
Aditya R. Daftary

Abstract Aim To demonstrate the role of radiographs and ultrasound (USG) in the diagnosis of calcific tendinitis and periarthritis in the wrist and hand and the efficacy of USG-guided barbotage for its management. Materials and Methods A retrospective chart review was performed in six patients who presented with acute-onset pain in the wrist and hand varying from 3 days to 2 weeks. Four patients had tenderness over pisiform and two patients had pain along the lateral aspect of the wrist and thumb. Radiographs and USG revealed calcific focus corresponding to the site of pain. USG-guided calcific barbotage and injection was performed for the same and pain relief was assessed immediately and through telephonic follow-up at 6 months using subjective satisfaction score. Data were analyzed using Microsoft Excel 2013. Results Four patients with tenderness over pisiform had flexor carpi ulnaris calcific tendinitis and two patients with pain along the lateral aspect of the wrist and thumb had first metacarpophalangeal calcific periarthritis and abductor pollicis brevis calcific tendinitis on radiographs as well as USG. In post-USG-guided calcific barbotage and injection, all patients had significant immediate and 6 months delayed relief in symptoms with excellent satisfaction scores. Conclusion Acute calcific tendinitis/periarthritis is a benign and self-limiting inflammatory condition. Radiographs are extremely helpful in identifying calcific focus. Ultrasonography in experienced hands is the best modality to identify, confirm the symptomatic calcific focus, and perform USG-guided intervention. USG-guided calcific barbotage is the simplest, quickest, and effective way to treat this condition and avoid compromised functional capacity.

2020 ◽  
Author(s):  
Ryogo Furuhata ◽  
Noboru Matsumura ◽  
Akira Yoshiyama ◽  
Yusaku Kamata ◽  
Masaaki Takahashi ◽  
...  

Abstract BackgroundCalcific tendinitis of the rotator cuff is a common disorder that causes acute onset of shoulder pain when spontaneous resorption of the calcification occurs.However, factors that triggercalcium resorption have not been clarified. The present study aimed to investigate the association between the onset of calcium resorption in calcific tendinitis and the season of onset.MethodsWe retrospectively reviewed200 patients (female, 120; male, 80; mean age, 62.8 ± 14.2 years) diagnosed with acute calcific tendinitis between 2006 and 2018. The onset date of acute calcific tendinitis for each patient was collected from clinical notes. The incidence of acute calcific tendinitis in each season and month and the correlation between the incidence of acute calcific tendinitis and the mean monthly temperature or humidity levels were evaluated.Results The most common season of acute calcific tendinitis onset was summer (35.5%), followed by spring (24.5%), autumn (24.0%), and winter (16.0%) (P = 0.002). Monthly analyses showed the highest peak of onset was in July (15.5%) and the lowest peak was in February (3.0%) (P = 0.018).The incidence of acute calcific tendinitis had a weak association with mean monthly temperature (R2 = 0.074; P = 0.001), but was not associated with mean monthly humidity levels (R2 = 0.024; P = 0.055).ConclusionsThis study provides new information on seasonal variation of acute calcific tendinitis onset. The results of this study indicated that the onset of calcium resorption occurs most frequently in the summer in Japan; however, the reasons for seasonal variation remain unclear, and further studies will be needed.


2020 ◽  
Author(s):  
Ryogo Furuhata ◽  
Noboru Matsumura ◽  
Akira Yoshiyama ◽  
Yusaku Kamata ◽  
Masaaki Takahashi ◽  
...  

Abstract Background Calcific tendinitis of the rotator cuff is a disorder that causes acute onset of shoulder pain when spontaneous resorption of the calcification occurs. However, factors that trigger calcium resorption have not been clarified. The present study aimed to investigate the association between the onset of calcium resorption in calcific tendinitis and the season of onset.Methods We retrospectively reviewed 195 patients (female, 116; male, 79; mean age, 62.6 ± 14.2 years; median age, 62 [52, 73] years) diagnosed with the postcalcification stage of calcific tendinitis, which was defined as acute calcific tendinitis in this study, between 2006 and 2018. The onset date of acute calcific tendinitis for each patient was collected from clinical notes. We evaluated the incidence of acute calcific tendinitis in each season and month. Furthermore, we investigated the correlation between the incidence of acute calcific tendinitis and the mean monthly temperature or humidity levels for each year.Results The most common season of acute calcific tendinitis onset was summer (35.4%), followed by spring (24.6%), autumn (24.1%), and winter (15.9%) (P = 0.002). Monthly analyses showed the highest peak of onset was in July (15.4%) and the lowest peak was in February (3.1%) (P = 0.022). The incidence of acute calcific tendinitis had a weak association with mean monthly temperature (R2 = 0.066; P = 0.001) but was not associated with mean monthly humidity levels (R2 = 0.018; P = 0.099).Conclusions This study provides new information on seasonal variation of acute calcific tendinitis onset. The results of this study indicated that the onset of calcium resorption occurs most frequently in the summer in Japan; however, the reasons for seasonal variation remain unclear, and further studies will be needed.


2020 ◽  
Author(s):  
Ryogo Furuhata ◽  
Noboru Matsumura ◽  
Akira Yoshiyama ◽  
Yusaku Kamata ◽  
Masaaki Takahashi ◽  
...  

Abstract Background Calcific tendinitis of the rotator cuff is a disorder that causes acute onset of shoulder pain when spontaneous resorption of the calcification occurs. However, factors that trigger calcium resorption have not been clarified. The present study aimed to investigate the association between the onset of calcium resorption in calcific tendinitis and the season of onset. Methods We retrospectively reviewed 195 patients ( female, 116; male, 79; mean age, 62.6 ± 14.2 years; median age, 62 [52, 73] years) diagnosed with the postcalcification stage of calcific tendinitis, which was defined as acute calcific tendinitis in this study, between 2006 and 2018. The onset date of acute calcific tendinitis for each patient was collected from clinical notes. We evaluated the incidence of acute calcific tendinitis in each season and month. Furthermore, we investigated the correlation between the incidence of acute calcific tendinitis and the mean monthly temperature or humidity levels for each year. Results The most common season of acute calcific tendinitis onset was summer (35.4%), followed by spring (24.6%), autumn (24.1%), and winter (15.9%) ( P = 0.002). Monthly analyses showed the highest peak of onset was in July (15.4%) and the lowest peak was in February (3.1%) ( P = 0.022). The incidence of acute calcific tendinitis had a weak association with mean monthly temperature (R 2 = 0.066; P = 0.001) but was not associated with mean monthly humidity levels (R 2 = 0.018; P = 0.099). Conclusions This study provides new information on seasonal variation of acute calcific tendinitis onset. The results of this study indicated that the onset of calcium resorption occurs most frequently in the summer in Japan; however, the reasons for seasonal variation remain unclear, and further studies will be needed.


2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Ryogo Furuhata ◽  
Noboru Matsumura ◽  
Akira Yoshiyama ◽  
Yusaku Kamata ◽  
Masaaki Takahashi ◽  
...  

Abstract Background Calcific tendinitis of the rotator cuff is a disorder that causes acute onset of shoulder pain when spontaneous resorption of the calcification occurs. However, factors that trigger calcium resorption have not been clarified. The present study aimed to investigate the association between the onset of calcium resorption in calcific tendinitis and the season of onset. Methods We retrospectively reviewed 195 patients (female, 116; male, 79; mean age, 62.6 ± 14.2 years; median age, 62 [52, 73] years) diagnosed with the postcalcification stage of calcific tendinitis, which was defined as acute calcific tendinitis in this study, between 2006 and 2018. The onset date of acute calcific tendinitis for each patient was collected from clinical notes. We evaluated the incidence of acute calcific tendinitis in each season and month. Furthermore, we investigated the correlation between the incidence of acute calcific tendinitis and the mean monthly temperature or humidity levels for each year. Results The most common season of acute calcific tendinitis onset was summer (35.4%), followed by spring (24.6%), autumn (24.1%), and winter (15.9%) (P = 0.002). Monthly analyses showed the highest peak of onset was in July (15.4%) and the lowest peak was in February (3.1%) (P = 0.022). The incidence of acute calcific tendinitis had a weak association with mean monthly temperature (R2 = 0.066; P = 0.001) but was not associated with mean monthly humidity levels (R2 = 0.018; P = 0.099). Conclusions This study provides new information on seasonal variation of acute calcific tendinitis onset. The results of this study indicated that the onset of calcium resorption occurs most frequently in the summer in Japan; however, the reasons for seasonal variation remain unclear, and further studies will be needed. Level of evidence Level III.


2021 ◽  
Vol 3 (1) ◽  
Author(s):  
Hession E ◽  
◽  
Ryan J ◽  

Introduction: Calcific tendinitis is an uncommon presentation in the forefoot with relatively few cases reported in the medical literature. It is commonly overlooked and should form part of a differential diagnosis when assessing patients presenting with acute pain of the forefoot localised to a single joint or tendon. We present two cases of young women involved in amateur running and martial arts respectively who presented with acute pain of their forefoot. Case Description: These 2 cases describe a 44 year old amateur female runner and 23 year old female martial arts athlete who presented with acute onset of pain affecting the dorsal aspect of their great toe interphalangeal joint and base of 1st metatarsal respectively. Both patients had tender erythematous swellings at the site of pain and difficulty weightbearing. Plain radiography revealed areas of calcification at the respective sites which was confirmed with ultrasound. Both patients underwent US guided corticosteroid injections with significant symptom improvement within 48 hours of injections and rapid return to sport. Discussion: These two cases demonstrate an atypical presentation of acute calcific tendinitis affecting the forefoot and add two more cases to the reported literature. Combining the characteristic clinical presentation of acute pain affecting a tendon or joint with a tender erythematous swelling on examination with the typical radiographic features of calcification can promptly diagnose this often misdiagnosed condition and avoid unnecessary investigations. Conservative treatment and intralesional injection with corticosteroids can lead to rapid resolution and favourable patient outcomes.


2018 ◽  
Vol 2018 ◽  
pp. 1-3 ◽  
Author(s):  
Man R. Shim

Acute calcific tendonitis is a common cause of musculoskeletal pain. However, it seldom affects the hand and wrist. For that reason, it is frequently mistaken for more common etiologies. This study reports a case of acute calcific tendinitis of the flexor carpi ulnaris, which was initially misdiagnosed as cellulitis, in a 65-year-old woman, who was unnecessarily prescribed with antibiotics. However, further evaluation confirmed the correct diagnosis of acute calcific tendinitis and her symptoms were subsequently resolved within 2 weeks with rest, wrist immobilization, and an intake of anti-inflammatories. This case underscores the need for the physicians to be aware of this less common but important cause of acute wrist pain in order to prevent misdiagnosis and avoid unnecessary medical treatments.


2020 ◽  
Vol 17 (4) ◽  
pp. 553-555
Author(s):  
Ravi Bhandari ◽  
Ritesh Sinha ◽  
Nirab Kayastha ◽  
Amit Joshi

Calcific tendinitis occurs frequently in shoulder and hip region. Its occurrence in elbow joint is frequently misdiagnosed because of its rare incidence and similar clinical presentation with other acute conditions of elbow like trauma, infection and tennis elbow. Characteristic symptoms of this condition are acute onset of pain, tenderness and swelling on the lateral aspect the elbow. Plain Radiograph is the primary modality to distinguish and evaluate this condition. Awareness and familiarity with this condition helps in early diagnosis and avoids unnecessary treatments and biopsy as this condition is self-limited.Keywords: Calcific tendinitis; self-limited; tennis elbow.


2020 ◽  
Vol 17 (3) ◽  
Author(s):  
Hossein Ghanaati ◽  
Zohreh Makki ◽  
Saeid Mardpour

: Calcific tendinitis of flexor carpi ulnaris (FCU) at the wrist is an extremely rare cause of ulnar side pain of the wrist. Owing to the infrequency of this entity, most cases are misdiagnosed as other diseases such as fractures, tendinopathies or infection. We present a case of recent-onset ulnar side wrist pain and swelling with a normal radiography. This case was referred to the imaging clinic to obtain magnetic resonance imaging (MRI) to rule out Kienbock disease. Multimodality imaging examination confirmed the correct diagnosis of acute calcific tendinitis. After two weeks of rest, wrist immobilization by splinting and consumption of anti-inflammatories, the patient’s symptoms were resolved. To conclude, this case emphasizes the requirement of awareness about this uncommon but important cause of acute wrist pain and the need of applying imaging methods for an early and accurate diagnosis in order to avoid misdiagnosis and unwarranted treatments.


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