scholarly journals Seasonal Variation in the Onset of Acute Calcific Tendinitis of Rotator Cuff

2020 ◽  
Author(s):  
Ryogo Furuhata ◽  
Noboru Matsumura ◽  
Akira Yoshiyama ◽  
Yusaku Kamata ◽  
Masaaki Takahashi ◽  
...  
Keyword(s):  
Seasonal Variation ◽  
Rotator Cuff ◽  
Acute Onset ◽  
Calcific Tendinitis ◽  
Onset Date ◽  
Clinical Notes ◽  
Monthly Temperature ◽  
New Information ◽  
Acute Calcific Tendinitis ◽  
Calcium Resorption

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.

scholarly journals Seasonal Variation in the Onset of Acute Calcific Tendinitis of Rotator Cuff

2020 ◽  
Author(s):  
Ryogo Furuhata ◽  
Noboru Matsumura ◽  
Akira Yoshiyama ◽  
Yusaku Kamata ◽  
Masaaki Takahashi ◽  
...  
Keyword(s):  
Seasonal Variation ◽  
Rotator Cuff ◽  
Acute Onset ◽  
Calcific Tendinitis ◽  
Onset Date ◽  
Clinical Notes ◽  
Monthly Temperature ◽  
New Information ◽  
Acute Calcific Tendinitis ◽  
Calcium Resorption

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.

scholarly journals Seasonal Variation in the Onset of Acute Calcific Tendinitis of Rotator Cuff

2020 ◽  
Author(s):  
Ryogo Furuhata ◽  
Noboru Matsumura ◽  
Akira Yoshiyama ◽  
Yusaku Kamata ◽  
Masaaki Takahashi ◽  
...  
Keyword(s):  
Seasonal Variation ◽  
Rotator Cuff ◽  
Acute Onset ◽  
Calcific Tendinitis ◽  
Onset Date ◽  
Clinical Notes ◽  
Monthly Temperature ◽  
New Information ◽  
Acute Calcific Tendinitis ◽  
Calcium Resorption

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.

scholarly journals Seasonal variation in the onset of acute calcific tendinitis of rotator cuff

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Ryogo Furuhata ◽  
Noboru Matsumura ◽  
Akira Yoshiyama ◽  
Yusaku Kamata ◽  
Masaaki Takahashi ◽  
...  
Keyword(s):  
Seasonal Variation ◽  
Rotator Cuff ◽  
Acute Onset ◽  
Calcific Tendinitis ◽  
Onset Date ◽  
Level Of Evidence ◽  
Monthly Temperature ◽  
New Information ◽  
Acute Calcific Tendinitis ◽  
Calcium Resorption

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.

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

2021 ◽  
Author(s):  
Ankita Ahuja ◽  
Malini Lawande ◽  
Aditya R. Daftary
Keyword(s):  
Retrospective Chart Review ◽  
Acute Onset ◽  
Calcific Tendinitis ◽  
Management Tool ◽  
Lateral Aspect ◽  
Abductor Pollicis Brevis ◽  
Flexor Carpi Ulnaris ◽  
Acute Calcific Tendinitis ◽  
Delayed Relief

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.

scholarly journals Not Every Hot, Tender, Inflamed Joint is Infected (or Gout)!

2020 ◽  
Vol 2 (2) ◽  
pp. 1-5
Author(s):  
Etleva Bejko ◽  
◽  
Angela Gupta ◽  
Maya Mattar ◽  
◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Platelet Rich Plasma ◽  
Case Reports ◽  
Treatment Options ◽  
White Blood Cells ◽  
Rare Condition ◽  
Extracorporeal Shock Wave Therapy ◽  
Calcific Tendinitis ◽  
Extracorporeal Shock Wave ◽  
Acute Calcific Tendinitis

Calcific tendinitis is a rare condition that classically involves the rotator cuff. Only isolated case reports exist of the disease affecting other anatomical locations. Our case is noteworthy because it describes calcific tendinitis in an uncommon location; the flexor pollicis longus of the thumb. Calcific tendinitis has a prevalence of 3-10% in the general population, and is most commonly seen among women in their 4th to 6th decade of life. Calcific tendinitis is best diagnosed by imaging where plain radiography and ultrasound are both helpful for detecting calcifications. Blood tests are generally not used for making the diagnosis. However, elevated white blood cells and inflammatory markers (e.g. sedimentation rate and C-reactive protein) may be seen in the acute phase of calcific tendinitis, but are usually normal. Although the exact pathophysiology of calcific tendinitis is unknown. Calcific tendinitis condition is often self-limited and interventions (i.e. anti-inflammatory medications, analgesics, glucocorticoid injections, physical therapy) are used with a “try it and see” mindset. Other treatment options (extracorporeal shock wave therapy, therapeutic ultrasound, iontophoresis, platelet rich plasma) have been tried. Acute calcific tendinitis should be on the differential diagnosis for acute musculoskeletal pain—even pain that is not at the rotator cuff. This case demonstrates that pain that is associated with a tender, inflamed joint can be more than either infection or gout. It is important to recognize calcific tendinitis as a potential diagnosis, as this could prevent unnecessary interventions and therapy such as intravenous antibiotics.

Acute Calcific Tendinitis of the Forefoot in Young Women- A Presentation of Two Cases

2021 ◽  
Vol 3 (1) ◽  
Author(s):  
Hession E ◽  
◽  
Ryan J ◽  
Keyword(s):  
Young Women ◽  
Acute Pain ◽  
Martial Arts ◽  
Return To Sport ◽  
Acute Onset ◽  
Calcific Tendinitis ◽  
Symptom Improvement ◽  
Intralesional Injection ◽  
Uncommon Presentation ◽  
Acute Calcific Tendinitis

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.

Calcific tendinitis of the rotator cuff associated with intraosseous loculation: Two case reports

2009 ◽  
Vol 18 (6) ◽  
pp. e6-e8 ◽  
Author(s):  
Wilson C. Sola ◽  
Gregory N. Drake ◽  
Carlos H. Ramos ◽  
André Gomes ◽  
Gary M. Gartsman
Keyword(s):  
Rotator Cuff ◽  
Case Reports ◽  
Calcific Tendinitis

scholarly journals Relative Efficacy of Three of Nonsurgical Treatments for Calcific Tendinitis: Physical Therapy vs Steroid Injection vs Ultrasound-Guided Aspiration

2021 ◽  
Vol 9 (7_suppl4) ◽  
pp. 2325967121S0021
Author(s):  
Mauricio Drummond ◽  
Caroline Ayinon ◽  
Albert Lin ◽  
Robin Dunn
Keyword(s):  
Physical Therapy ◽  
Rotator Cuff ◽  
Conservative Treatment ◽  
Conservative Management ◽  
Surgical Intervention ◽  
Corticosteroid Injection ◽  
Calcific Tendinitis ◽  
Ultrasound Guided ◽  
Calcium Deposits

Objectives: Calcific tendinitis of the shoulder is a painful condition characterized by the presence of calcium deposits within the tendons of the rotator cuff (RTC) that accounts for up to 7% of cases of shoulder pain1. The most common conservative treatments typically include physical therapy (PT), corticosteroid injection (CSI), or ultrasound-guided aspiration (USA). When conservative management fails, the patient may require arthroscopic surgery to remove the calcium with concomitant rotator cuff repair. The purpose of this study was to characterize the failure rates, defined as the need for surgery, of each of these three methods of conservative treatment, as well as to compare post-operative improvement in patient-reported outcomes (PROs) – including subjective shoulder values (SSV) and visual analog scale (VAS) pain scores – based on the type of pre-operative conservative intervention provided. A secondary aim was to compare post-operative range of motion (ROM) outcomes between groups that failed conservative management. We hypothesized that all preoperative conservative treatments would have equivalent success rates, PROs, and ROM. Bosworth B. Calcium deposits in the shoulder and subacromial bursitis: a survey of 12122 shoulders. JAMA. 1941;116(22):2477-2489. Methods: A retrospective review of all patients who were diagnosed with calcific tendinitis at our institution treated among 3 fellowship trained orthopedic surgeons between 2009 and 2019 was performed. VAS, SSV, and ROM in forward flexion (FF) and external rotation (ER) was abstracted from the medical records. Scores were recorded at the initial presentation as well as final post-operative follow-up visit for those who underwent surgery. The conservative treatment method utilized by each patient was recorded and included PT, CSI, or USA. Failure of conservative management was defined as eventual progression to surgical intervention. Statistical analysis included chi-square, independent t test and ANOVA. Descriptive statistics were used to report data. A p<0.05 was considered to be statistically significant. Results: 239 patients diagnosed with calcific tendinitis were identified in the study period with mean age of 54 years and follow up of at least 6 months. In all, 206 (86.2%) patients underwent a method of conservative treatment. Of these patients, 71/239 (29.7%) underwent PT, 67/239 (28%) attempted CSI, and 68/239 (28.5%) underwent USA. The overall failure rate across all treatment groups was 29.1%, with injections yielding the highest success rate of 54/67 (80.6%). Physical therapy saw the highest failure rate, with 26/71 (36.7%) proceeding to surgical intervention. Patients undergoing physical therapy were statistically more likely to require surgery compared to those undergoing corticosteroid injection (RR 1.88, p= 0.024). Of all 93 patients who underwent surgery, VAS, SSV, ROM improved significantly in all groups. On average, VAS decreased by 4.02 points (6.3 to 2.3), SSV increased by 33 points (51 to 84), FF improved by 13.8º, and ER improved 8.4º between the pre- and post-operative visits (p<0.05). The 33 patients who did not attempt a conservative pre-operative treatment demonstrated the largest post-operative improvement in VAS (-6.00), which was significantly greater than those who previously attempted PT (-3.33, p<0.05). There was a trend towards greater improvement in SSV in the pre-operative PT group (45 to 81) compared to others, but this did not reach statistical significance (p=0.47). Range of motion was not significantly affected by the method of pre-operative conservative intervention. Conclusions: Conservative treatment in the form of physical therapy, corticosteroid injection, and ultrasound-guided aspiration is largely successful in managing calcific tendinitis of the shoulder. Of these, PT demonstrated the highest rate of failure in terms of requiring surgical management. PRO improvement varied among the conservative modalities used, however patients who did not attempt conservative management experienced the greatest improvements following surgery. If surgery is necessary following failed conservative treatment, excellent outcomes can be expected with significant improvements in ROM and PROs. This information should be considered by the surgeon when deciding whether to recommend conservative treatment for the management of calcific tendinitis, as well as which specific method to employ.

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