Learning objectives
- To assess the incidence of intraosseous migration of calcifications as a complication in the calcific tendinitis of the shoulder diagnosed in our center.
- Review the most relevant signs for the diagnosis,
mainly through magnetic resonance (MR) and the sequences that provide more information.
Background
Definition of calcific tendinitis and phases of the process:
Calcifications in the rotator cuff are a frequent cause of shoulder pain.
They are precipitated calcium hydroxyapatite crystals that are more frecuently deposited inthe supraspinatus tendon,
at 1 cm of its insertion,
followed by the infraspinatus and subscapularis.
This site of the tendon nearits insertion is the «critical» area because it's a zone of mechanical stress and hypoxia in which the deposition of calcifications is facilitated.
Stagesof the disease:
1.
Formative phase: Deposit of calcium in...
Findings and procedure details
We reviewed the cases of intraosseal migration of calcifications in calcific tendinitis of the shoulder that occurred from January 2012 to December 2017 in our center.
In the literature,
calcific tendonitis is described in around 3% of the adult population.
The complication of migration of calcifications through the bone has been described in several small series: eg 20 cases in a series from 1970 to 2000.Della Valle V,
Bassi EM,
Calliada F.
Migration of calcium deposits into subacromial-subdeltoid bursa and into humeral head as a...
Conclusion
- The intraosseous migration of calcifications is a low-frequency complication described.
- Cortical destruction and bone edema are the most relevant findings in magnetic resonance imaging.
- The MR sequence,
which in our opinion offers the greatest returns,
is the GE 3D T2,
where intraosseous calcifications are easily identified.
- It is important to take this entity into account and look for its signs on the MRI of the shoulder so that this complication isn't underdiagnosed.
References
- A.
Marinetti,
M.
Sessa,
A.
Falzone,
S.W.
Della Sala.
Intraosseous migration of tendinous calcifications: two case reports.
Skeletal Radiol 2018;47:131-136.
- S.
Martin,
J.M.
Rapariz.
Intraosseous calcium migration in calcifying tendinitis: a rare cause of single sclerotic injury in the humeral head (2010:2b).
Eur Radiol 2010;20:1284-1286.
- A. Alcalá-Galiano Rubio,
M.
Baeva Trunina,
M.J.
Argüeso Chamorro.
Formas especiales de tendininopatía calcificante insercional del manguito rotador,
con predominio de la afectación ósea.
A propósito de 3 casos.
Presentación electrónica científica Nº S-0274 SERAM 2012.
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