IN THE NAME OF GOD
CALCIFICATIN TEDINITIS
By: zohre dolatkhah
INTRODUCTION
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The part of the body where the humerus attaches
to the scapula.
The shoulder must be mobile enough for the
wide range actions of the arms and hands, but
also stable enough to allow actions such as
lifting, pushing and pulling.
It is made up of three bones.
Clavicle,
Scapula
Humerus.
Joints
of the shoulder:
1. Glenohumeral
joint (main one, ball and
socket joint, articulation between the glenoid fossa of
the scapula (shoulder blade) and the head of the
humerus
2. Acromioclavicular joint (articulation
between the acromion process of the scapula and the
lateral end of the clavicle )
3. Sternoclavicular joint
(articulation
between sternal end of the clavicle, and the manubrium
sterni
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There are two kinds of cartilage in the joint:
1. Articular cartilage : covers humerus head and
glenoid surface. It’s a white cartilage which
allows the bones to glide and move on each other.
When this type of cartilage starts to wear out (a
process called arthritis), the joint becomes
painful and stiff.
2. Labrum : its a ring of rigid fibrous cartilage
surrounding the glenoid cavity, it stabilizes the
ball and socket joint!
ROTATOR CUFF MUSCLES
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The group of four muscles and their tendons
that act to stabilize the shoulder .
*the strength of the joint depend on the tone of
these group of muscle which across in
front,above ,behind the jont
1- Supraspinatous – abducts the arm
2- Infraspinatous – external rotation
3- Teres Minor – external rotation
4- Subscapularis – internal rotation
ANATOMY
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These muscles arise from the scapula and
connect to the head of the humerus, forming
 a cuff at the shoulder joint.
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They hold the head of the humerus in the
small and shallow glenoid fossa of the scapula.
Nerve supply:axillary and suprascapular nerve
Calcific Tendinitis
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A disorder characterized by deposits of crytalline
calcium phosphate in any tendon of the rotator cuff
muscles causing inflammation and pain.
It is of unknown etiology.
Most people over the age of 40
Pain is aggravated by elevation of the arm above
shoulder level or by lying on the shoulder.
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sever Pain may awaken the patient from sleep.
its one of the most painful conditions in the
shoulder
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When this condition is symptomatic, it may
present in the following 2 ways:
•
Chronic, relatively mild pain with intermittent
flares, similar to shoulder impingement
syndrome, is believed to indicate that the
condition is in the formative phase.
•
Mechanical symptoms may arise from a large
calcific deposit → build up of pressure in the
tendon→intense pain→limitation of movement
There are three types of shoulder tendinitis.
1. rotator cuff
2. calcific tendinitis
3.biceps tendinitis
The rotator cuff consists of four muscles around
the shoulder joint that help control the
shoulders position and keep it stable. With
rotator cuff tendinitis the pain is located about
three inches below the top of the shoulder and
is felt when reaching over head or behind the
back. Rotator cuff tendinitis will usually
resolve with rest, anti-inflammatory
medications or an injection of cortisone and a
local anesthetic into the areas surrounding the
tendon, as well as exercising using light
weights
Calcific tendinitis is caused by calcium deposits in
the rotator cuff region. Symptoms include
excruciating pain and sever restriction of
shoulder motion. X-rays reveal calcium
deposits within the rotator cuff or overlying the
head of the humerus. Treatment includes
injection of cortisone and a local anesthetic into
the area surrounding the tendon. Multiple
needle punctures into the calcium deposit may
break up the deposit.
Biceps tendinitis is inflammation of the biceps
tendons that attach to the shoulder. Biceps
tendons that attach to the shoulder. Biceps
tendinitis usually affects individuals whose
occupation involves repetitive biceps flexion
against resistance or whose activities include
forceful throwing of a ball. Biceps tendinitis will
resolve with rest, anti-inflammatory
medications or an injection of cortisone and a
local anesthetic into the area surrounding the
tendon, as well as a sling to immobilize the
shoulder. Surgery is occasionally required to
stabilize a displaced tendon
CAUSES AND RISK FACTORS OF TENDINITIS
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The most common causes of tendinitis are injury,
overuse, infection of the tendon sheath or disease
(tendinitis is evident in rheumatoid arthritis,
gout and psoriatic arthritis). More often than not,
the cause of tendinitis is unknown
PREVENTION OF TENDINITIS
Proper conditioning
 Gradual introduction of activity
 Warm-up and stretching prior to exercise
 Wearing appropriate shoes for the activity
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DIAGNOSIS OF TENDINITIS
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In order to properly and accurately diagnose
tendinitis a careful study of medical history
and physical examination is required by the
health care provider. X-rays are of great help
for excluding any bone abnormalities or
conditions like arthritis. As tendons are not
generally visible to the naked eyes on x-rays.
MRI’s and ultrasound are often found to be
useful in the detection of tendinitis. Blood tests
may be taken in order to confirm presence of
any other underlying conditions. But such
tests are generally not necessary in the process
of diagnosing tendinitis.
 Diagnoses
by :
Xray
 Ultrasound (more accurate)
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calcific deposits are visible as lumps or cloudy
areas. Mostly found on the greater tuberosity
TREATMENT
NSAID injection
 Injections, needling, and lavage Breaking up the calcific
deposits by repeatedly puncturing them with a needle,
aspirating the calcific material, with the help of saline.
 Surgery(rarely required)
 Physiotherapy to regain muscle strength
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THANKS FOR YOUR ATTENTION