obsolete calcium deposits in tendon and bursa

Calcium Deposits in Tendon and Bursa: An Obsolete Condition

Calcium deposits in tendon and bursa refer to the accumulation of calcium crystals within the tendons and surrounding bursae, which is an outdated term for calcific tendinopathy or calcifying tendinitis. This condition was previously known as periarticular apatite deposition disease.

Characteristics:

• Calcium deposits form in the tendons, particularly around the shoulder joint.
• The deposits can also be found in the surrounding bursae, which are fluid-filled sacs that cushion joints and reduce friction between bones.
• This condition is often associated with chronic inflammation and tissue damage.

Types of Calcification:

There are three types of calcifications observed in tendons and bursa:

1. Type I: Characterized by small, well-defined calcium deposits.
2. Type II: Features larger, more amorphous calcium deposits.
3. Type III (Slurry): Calcium deposits that appear semiliquid or "slurry-like" and may be isoechoic to tendons.

Complications:

Calcium deposit migration from tendons to adjacent structures is an uncommon complication of calcifying tendonitis, where intratendinous calcifications are extruded into the sub-bursal space or intra-subacromial–subdeltoid bursa (more frequently) or into the humeral head (less frequently).

References:

• [6] describes calcium deposits in tendon and bursa as an obsolete condition.
• [11] mentions calcium deposit migration from tendons to adjacent structures as a complication of calcifying tendonitis.
• [14] discusses the different types of calcifications observed in tendons and bursa.

Common Signs and Symptoms of Obsolete Calcium Deposits in Tendon and Bursa

Calcium deposits, also known as calcifications, can occur in tendons and bursae, leading to various symptoms. Here are some common signs and symptoms associated with obsolete calcium deposits in tendon and bursa:

• Pain: Pain is the most frequent symptom of calcific tendonitis or calcific bursitis, which can be severe and debilitating [11][12].
• Reduced Movement: Calcium deposits can lead to reduced movement or stiffness in the affected area, making it difficult to perform daily activities [4][10].
• Swelling: Swelling and redness may occur around the affected tendon or bursa, indicating inflammation [8][9].
• Weakness: Weakness in the affected muscle or tendon can also be a symptom of calcific tendonitis or calcific bursitis [2][3].
• Limited Range of Motion: The range of motion in the affected joint may be limited due to pain and stiffness [5][6].

Specific Symptoms by Location

• Shoulder: In the shoulder, calcific tendonitis can cause pain and reduced movement in the upper arm and shoulder, as well as stiffness and weakness [10].
• Knee: In the knee, calcific bursitis can cause pain and limited motion, along with swelling and redness over the kneecap [5].

Other Symptoms

• Crepitation: Crepitation or a grating sensation may be felt within the affected tendon or bursa [8].
• Pain on Rubbing: Pain elicited by rubbing the tendon between the fingers is a sign of peritendonitis [8].

These symptoms can vary in severity and duration, depending on the location and extent of the calcium deposits. If you are experiencing any of these symptoms, it is essential to consult with a healthcare professional for proper diagnosis and treatment.

Diagnostic Tests for Obsolete Calcium Deposits in Tendon and Bursa

Calcific tendinitis, also known as calcifying tendinitis, is a condition characterized by the deposition of calcium in the tendons and surrounding bursae. The following diagnostic tests can be used to identify obsolete calcium deposits in tendon and bursa:

• Radiographs: Orthogonal radiographs of the shoulder can show calcium deposits overlying the rotator cuff insertion, making it possible to diagnose calcific tendonitis [15].
• Sonography: Ultrasonography can be used for diagnosis, showing the presence of calcium deposits in the tendons and surrounding bursae [13].
• Standard Radiographs: Standard radiographs can also be used to show the presence of calcium deposits in the tendons and surrounding bursae [13].

Other Diagnostic Considerations

When diagnosing calcific tendonitis, it is essential to consider other differential diagnoses that may present with similar symptoms. These include:

• Infection
• Arthritis
• Lumbar radiculopathy
• Os acetabuli
• Avulsion fracture
• Insertional calcified bursitis
• Sesamoid bones
• Myositis ossificans
• Chondrosarcoma [13]

Interpretation of Diagnostic Tests

The interpretation of diagnostic tests for calcific tendonitis should be done by a qualified healthcare professional. The presence of calcium deposits in the tendons and surrounding bursae, as seen on radiographs or sonography, can confirm the diagnosis.

References:

[13] - Depending on the affected tendon, the differential diagnosis includes infection [124, 180], arthritis, lumbar radiculopathy [126, 140, 168], os acetabuli, avulsion fracture, insertional calcified bursitis, sesamoid bones, myositis ossificans and chondrosarcoma . Sonography and standard radiographs can be used for diagnosis, showing the presence of calcium deposits in the tendons and surrounding bursae.

[15] - Calcific tendonitis is the calcification and tendon degeneration near the rotator cuff insertion, most commonly leading to shoulder pain with decreased range of motion. Diagnosis can be made radiographically with orthogonal radiographs of the shoulder showing calcium deposits overlying the rotator cuff insertion.

Treatment Options for Calcific Tendonitis and Bursitis

Calcific tendonitis and bursitis are conditions characterized by the accumulation of calcium deposits in tendons and bursae, leading to pain and inflammation. While there is no definitive cure, various treatment options can help alleviate symptoms.

• Medications: Anti-inflammatory medications such as cortisone injections can be administered directly into the affected area to reduce inflammation and relieve pain [1]. Additionally, non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen can be prescribed to manage pain and inflammation [10].
• Corticosteroid Injections: Corticosteroids are powerful anti-inflammatory agents that can be injected directly into the affected area to reduce swelling and relieve pain. However, repeated steroid injections can weaken tendons and increase the risk of tendon tears [3].
• Physical Therapy: Physical therapy can help improve range of motion, strengthen surrounding muscles, and promote healing in the affected area [4]. A physical therapist can create a customized exercise program to address specific needs.
• Ultrasound-Guided Needle Treatment: This minimally invasive procedure involves using ultrasound guidance to insert a needle into the affected area, allowing for the delivery of medication or other treatments directly to the site [2].
• Shockwave Therapy: High-energy shockwave therapy has been shown to be effective in treating calcific tendonitis, with reported success rates ranging from 50% to 70% after one or two treatments [13]. However, this treatment can be painful and may require anesthesia.

Important Considerations

While these treatment options can help manage symptoms, it's essential to note that calcific tendonitis and bursitis can be chronic conditions. A comprehensive treatment plan should address the underlying causes of the condition, as well as any contributing factors such as poor posture or repetitive strain injuries.

References:

[1] Health A-Z. Calcific Bursitis Treatment.

[2] Vignesh KN, McDowall A, Simunovic N, Bhandari M, Choudur HN. Efficacy of ultrasound-guided percutaneous needle treatment of calcific tendinitis.

[3] Sep 21, 2018 — Corticosteroid injections for subacromial impingement and bursitis.

[4] by V Chianca · 2018 · Cited by 145 — Treatment options for calcific tendonitis.

[10] What is the treatment for calcific tendonitis?

[13] Most reports on this method of treatment of calcific tendonitis show guarded success—perhaps 50 to 70 percent of patients improving after one or two high-energy shockwave treatments.

Differential Diagnosis of Calcific Tendinitis and Bursitis

Calcific tendinitis and bursitis are conditions characterized by the deposition of calcium crystals in tendons and bursae, respectively. When diagnosing these conditions, it's essential to consider differential diagnoses that can mimic or coexist with calcific tendinitis and bursitis.

Common Differential Diagnoses:

• Tendonitis: Inflammation of a tendon, which can be caused by overuse, injury, or other factors.
  • According to [8], common conditions of the Achilles tendon include tendonitis, peritendonitis, tendinosis, rupture, and retrocalcaneobursitis. (Source: 8)
• Peritendonitis: Inflammation of the tissue surrounding a tendon.
  • As mentioned in [8], this condition can coexist with calcific tendinitis. (Source: 8)
• Tendinosis: A degenerative condition affecting the tendon, which can be caused by repetitive strain or other factors.
  • According to [8], tendinosis is another common condition of the Achilles tendon. (Source: 8)
• Retrocalcaneobursitis: Inflammation of a bursa located near the heel bone.
  • As mentioned in [8], this condition can coexist with calcific tendinitis and other conditions affecting the Achilles tendon. (Source: 8)
• Bursitis: Inflammation of a bursa, which is a fluid-filled sac that cushions joints and reduces friction between bones and soft tissues.
  • According to [10], bursitis can be caused by inflammation of a bursa at the site of bony prominences between muscles or tendons. (Source: 10)
• Calcific Bursitis: Deposition of calcium in a bursa, which can cause pain and stiffness.
  • As mentioned in [10], calcific bursitis is a specific type of bursitis characterized by the deposition of calcium crystals in a bursa. (Source: 10)

Other Differential Diagnoses:

• Vascular conditions: Such as venous insufficiency, which can cause pain and swelling in the affected area.
  • According to [3], vascular conditions are one of the differential diagnoses for dystrophic soft tissue calcifications. (Source: 3)
• Infection: Bacterial or fungal infections can cause inflammation and pain in the affected area.
  • As mentioned in [3], infection is another differential diagnosis for dystrophic soft tissue calcifications. (Source: 3)
• Parasitic infestation: Such as cysticercosis, which can cause calcification of tissues.
  • According to [3], parasitic infestation is a rare but possible differential diagnosis for dystrophic soft tissue calcifications. (Source: 3)

Conclusion

When diagnosing calcific tendinitis and bursitis, it's essential to consider these differential diagnoses to ensure accurate diagnosis and treatment. By considering the common conditions that can mimic or coexist with calcific tendinitis and bursitis, healthcare professionals can provide effective care for patients with these conditions.

References:

[1] A DE CARLI · 2014 [2] H Jo · 2016 [3] Generic Differential Diagnosis of Dystrophic Soft Tissue Calcifications [4] by MR Shim · 2018 [5] Calcific tendinopathy (also known as calcific tendonitis) [6] by F Al-Ashkar [7] Calcific tendinitis means calcium deposits in the area of the shoulder joint. [8] by MF MAZZONE · 2002 [9] Ultrasound shows concomitant bursitis and is useful for the differential diagnosis ... [10] bursitis: inflammation of a bursa at site of bony prominences between muscles or tendons. calcific bursitis: deposition of calcium in a bursa, usually ...