Rotator cuff calcific tendinopathy: from diagnosis to treatment

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Abstract

Rotator cuff calcific tendinopathy (RCCT) is a very common condition caused by the presence of calcific deposits in the rotator cuff (RC) or in the subacromial-subdeltoid (SASD) bursa when calcification spreads around the tendons. The pathogenetic mechanism of RCCT is still unclear. It seems to be related to cell-mediated disease in which metaplastic transformation of tenocytes into chondrocytes induces calcification inside the tendon of the RC. RCCT is a frequent finding in the RC that may cause significant shoulder pain and disability. It can be easily diagnosed with imaging studies as conventional radiography (CR) or ultrasound (US). Conservative management of RCCT usually involves rest, physical therapy, and oral NSAIDs administration. Imaging-guided treatments are currently considered minimally-invasive, yet effective methods to treat RCCT with about 80% success rate. Surgery remains the most invasive treatment option in chronic cases that fail to improve with other less invasive approaches. (www.actabiomedica.it)

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Most cited references 126

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Calcific tendinitis of the shoulder.

B Hazleman, William C Speed (1999)

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A novel Ca²⁺-mediated cross-talk between endoplasmic reticulum and acidic organelles: implications for NAADP-dependent Ca²⁺ signalling.

Virginia Ronco, Duilio Michele Potenza, Federico Denti … (2015)

Nicotinic acid adenine dinucleotide phosphate (NAADP) serves as the ideal trigger of spatio-temporally complex intracellular Ca(2+) signals. However, the identity of the intracellular Ca(2+) store(s) recruited by NAADP, which may include either the endolysosomal (EL) or the endoplasmic reticulum (ER) Ca(2+) pools, is still elusive. Here, we show that the Ca(2+) response to NAADP was suppressed by interfering with either EL or ER Ca(2+) sequestration. The measurement of EL and ER Ca(2+) levels by using selectively targeted aequorin unveiled that the preventing ER Ca(2+) storage also affected ER Ca(2+) loading and vice versa. This indicates that a functional Ca(2+)-mediated cross-talk exists at the EL-ER interface and exerts profound implications for the study of NAADP-induced Ca(2+) signals. Extreme caution is warranted when dissecting NAADP targets by pharmacologically inhibiting EL and/or the ER Ca(2+) pools. Moreover, Ca(2+) transfer between these compartments might be essential to regulate vital Ca(2+)-dependent processes in both organelles.

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Rotator cuff calcific tendonitis: short-term and 10-year outcomes after two-needle us-guided percutaneous treatment--nonrandomized controlled trial.

Alberto Aliprandi, Giovanni Serafini, Francesco Sardanelli … (2009)

To compare short- and long-term outcomes of patients with rotator cuff calcific tendonitis who did and did not undergo ultrasonographically (US)-guided percutaneous treatment. Institutional review board approval and informed patient consent were obtained. Of patients referred for US-guided treatment of rotator cuff calcific tendonitis, 219 (86 men, 133 women; mean age, 40.3 years +/- 10.9 [standard deviation]) were treated; 68 (31 men, 37 women; mean age, 40.2 years +/- 11.3) patients refused treatment and served as control subjects. After local anesthesia was induced, two 16-gauge needles were inserted into the calcific deposit. Saline solution was injected through one needle, and the dissolved calcium was extracted through the other needle. Shoulder joint function was assessed by using Constant scores, and pain was assessed by using visual analogue scale (VAS) scores. Mann-Whitney U and chi(2) tests were performed. At baseline, no significant difference in age or sex distribution, Constant score, or VAS score was detected between treated and nontreated (control) patients. Compared with control subjects, treated patients reported a significant decrease in symptoms at 1 month (mean Constant score, 73.2 +/- 6.2 vs 57.5 +/- 3.9; mean VAS score, 4.8 +/- 0.6 vs 9.1 +/- 0.5), 3 months (mean Constant score, 90.2 +/- 2.6 vs 62.6 +/- 7.2; mean VAS score, 3.3 +/- 0.4 vs 7.3 +/- 1.8), and 1 year (mean Constant score, 91.7 +/- 3.1 vs 78.4 +/- 9.5; mean VAS score, 2.7 +/- 0.5 vs 4.5 +/- 0.9) (P or= .795) and 10 years (mean Constant score, 91.8 +/- 5.0 vs 91.3 +/- 9.6; mean VAS score, 2.5 +/- 0.6 vs 2.7 +/- 0.6) (P >or= .413). US-guided percutaneous treatment facilitated prompt shoulder function recovery and pain relief. Treated patients had better outcomes than did nontreated patients at 1 year. However, 5 and 10 years after the procedure, the nontreated group reported outcomes similar to those of the treated group. (c) RSNA, 2009.

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Journal

Journal ID (nlm-ta): Acta Biomed

Journal ID (iso-abbrev): Acta Biomed

Title: Acta bio-medica : Atenei Parmensis

Publisher: Mattioli 1885 (Italy )

ISSN (Print): 0392-4203

Publication date (Print): 2018

Volume: 89

Issue: Suppl 1

Pages: 186-196

Affiliations

[1 ]Department of Advanced Biomedical Sciences, Federico II University, Napoli, Italy

[2 ]Department of Radiology, DIBIMED, University of Palermo, Palermo, Italy

[3 ]Scuola di Specializzazione in Radiodiagnostica, Università degli Studi di Milano, Milano, Italy

[4 ]University of Palermo, Palermo, Italy

[5 ]Division of Interventional Radiology, Istituto Europeo di Oncologia, Milano, Italy

[6 ]Unit of Radiology, Istituti Clinici Zucchi, Monza, Italy

[7 ]Unit of Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Galeazzi, Milano, Italy

[8 ]Unit of Diagnostic and Interventional Radiology, Università dell’Aquila, Italy

[9 ]Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milano, Italy

Author notes

Correspondence: Luca Maria Sconfienza Unit of Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Galeazzi, Milano Phone +39 02 6621 4497 E-mail: io@ 123456lucasconfienza.it

Article

Publisher ID: ACTA-89-186

DOI: 10.23750/abm.v89i1-S.7022

PMC ID: 6179075

PubMed ID: 29350647

SO-VID: b7e34045-1751-4c0e-a117-2b0d13ee7695

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This work is licensed under a Creative Commons Attribution 4.0 International License

Rotator cuff calcific tendinopathy: from diagnosis to treatment

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Most cited references 126

Calcific tendinitis of the shoulder.

A novel Ca²⁺-mediated cross-talk between endoplasmic reticulum and acidic organelles: implications for NAADP-dependent Ca²⁺ signalling.

Rotator cuff calcific tendonitis: short-term and 10-year outcomes after two-needle us-guided percutaneous treatment--nonrandomized controlled trial.

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