Musculoskeletal Medicine and PainCLINICAL PRACTICE

Clinical evaluation and management of calcific tendinopathy: an evidence-based review

Michael Catapano, MD; David M. Robinson, MD; Sean Schowalter, MD; and Kelly C. McInnis, DO
Notes and Affiliations
Notes and Affiliations

Received: August 25, 2021

Accepted: November 29, 2021

Published: February 4, 2022

  • Michael Catapano, MD, 

    Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital/Harvard Medical School, Boston, MA, USA

  • David M. Robinson, MD, 

    Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN, USA

  • Sean Schowalter, MD, 

    Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital/Harvard Medical School, Boston, MA, USA

  • Kelly C. McInnis, DO, 

    Department of Physical Medicine and Rehabilitation and Division of Sports Medicine, Massachusetts General Hospital and Spaulding Rehabilitation Hospital/Harvard Medical School, Boston, MA, USA

J Osteopath Med; 122(3): 141-151
Abstract

Calcific tendinopathy (CT) is an important musculoskeletal condition most commonly seen in the shoulder girdle, accounting for 10–42% of all shoulder pain. Despite the high prevalence within the shoulder region, CT has been demonstrated in many tendons throughout the axial and appendicular skeleton. Unlike degenerative tendinopathies, CT appears to be a self-limiting condition that affects otherwise-healthy tendon with deposition of calcium hydroxyapatite crystals between healthy tenocytes. In patients with functionally limiting symptoms or pain, the clinical course may be accelerated through a multitude of treatments including physical therapy and pain management, extracorporeal shock wave therapy, ultrasound-guided percutaneous lavage (UGPL), and operative debridement. Currently, the most efficacious and frequently utilized treatment for shoulder CT is UGPL due to its ability to effectively reduce calcium burden and pain while limiting soft-tissue damage. However, more evidence regarding the treatment and course of CT is needed before determining the most appropriate treatment at all potential sites of CT.

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