Calcific Tendinitis of the Rotator Cuff

Calcific Tendinitis of the Rotator Cuff

Calcific tendinitis of the rotator cuff is a frequent cause of shoulder pain. This pain is so acute and incapacitating that it can disturb the patients' sleep for several days if left untreated.

This disease generally affects the supraspinatus and is caused by the accumulation of hydroxyapatite deposits (a crystalline calcium phosphate) in the tendons. The hydroxyapatite deposits can be seen through X-rays and ultrasound exams.

Treatment can be accomplished with non-invasive methods, which are usually our starting point, including: anti-inflammatory drugs (and eventually corticosteroids) as well as physiotherapy.

We have a shockwave therapy system that allows us to perform a sort of extracorporeal lithotripsy, similar to the well-established and tested treatment for kidney stones. Although its mechanism of action is not yet fully known, this is a process that applies pressure variations inside the shoulder, shattering the hydroxyapatite deposits into smaller fragments. Three sessions, one-week apart, are usually effective in easing this clinical picture (see the images in the "Physiotherapy" tab).

If this treatment is not fully effective, then it becomes necessary to remove the deposits.

Shoulder Arthroscopy

Ultrasound-guided fine needle aspiration (FNA) is one of the possibilities, however when treating large calcifications, arthroscopic procedures are better suited to remove them in a minimally invasive way.


The image on top shows a voluminous calcification in the supraspinatus (indicated by the arrow), while the image bellow shows the same shoulder after an arthroscopic cleaning procedure.