calcium hydroxyapatite crystal deposition disease ( RID3594 )
I think this is the largest intramuscular calcific deposit Ive seen and there is marked reactive soft tissue edema. Smaller calcifications are seen throughout the supraspinatus tendon, with tendon expansion, fraying and edema. A calcific deposit erodes into the anterior greater tuberosity. There is a tiny ca++ in the trans humeral ligament. I was taught by Bob Freiberger that there is almost never cuff tear with intratendinous Ca++. Im sure that came from many years of experience, but I dont know that I can r/o a partial tear in these cases (in the attached article they excluded 14/323 cases with ipsilateral RCT). As my colleague says, if we evacuate the Ca++, wont we leave a defect behind? What are your thoughts? [ Article ]
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47 yr old male with severe shoulder pain and calcifications on outside radiographs, asked to r/o rotator cuff tear
Courtesy Hilary Umans, MD
