Causation and management of calcific tendonitis and periarthritis

• Published in: Current opinion in rheumatology Vol. 25; no. 2; p. 204
• Main Authors: Carcia, Christopher R, Scibek, Jason S
• Format: Journal Article
• Language: English
• Published: United States 01.03.2013
• Subjects: Anti-Inflammatory Agents, Non-Steroidal - therapeutic use; Arthroscopy; Calcinosis - etiology; Calcinosis - therapy; High-Energy Shock Waves - therapeutic use; Humans; Periarthritis - etiology; Periarthritis - therapy; Platelet-Rich Plasma; Rotator Cuff; Shoulder Joint; Tendinopathy - etiology; Tendinopathy - therapy
• ISSN: 1531-6963
• DOI: 10.1097/BOR.0b013e32835d4e85

The purpose of this review is to update the reader on contemporary theory related to the cause of calcific periarthritis and provide the latest evidence associated with treating recalcitrant cases. Contemporary theory suggests calcific periarthritis is the result of a cellular-mediated process in which calcium is deposited and resorbed via a multiple phase process. Resorption is associated with an acute inflammatory response and is often the factor that prompts one to seek medical care. The majority of cases require nothing more than a combination of symptomatic care and benign neglect. A small percentage of cases require intervention to further stimulate deposit resorption. Moderate evidence exists for extracorporeal shock wave therapy in the treatment of chronic cases related to deposits about the shoulder. Numerous case studies support the use of NSAIDs as an effective intervention for retropharyngeal periarthritis. If conservative interventions fail, surgery appears to be a viable option for symptom relief associated with rotator cuff calcific deposits. Periarthritis is typically a symptom-limiting condition that resolves spontaneously. Numerous conservative treatment modalities each with varying levels of evidence exist for use in refractory cases. Future study is necessary to further refine the efficacy and parameters associated with available interventions.