- See:
Rotator
Cuff Tear:
- Discussion:
- deposits lie in the rotator cuff and contain H[2O, CO[3, & PO[4];
- usually does not occur until 4 th decade;
- diabetic patients are more likely to develop asymptomatic rotator
cuff calcium deposits;
- > 30% of insulin-dependent diabetics had tendon calcification
where as
< 10% of nondiabetics have this lesion;
-
classification:
- may be divided into acute & chronic phases;
- type I: calcific nodule has sharply defined edges;
- type II: mixture of cloudy and sharp edges;
- type III: cloudy edges and somewhat transparent;
- Indications for Treatment:
- in most cases, clinical symptoms will resolve spontaneously in 7-10 days
(where as the deposit
may persist on radiographs);
- w/ prolonged symptoms, consider cortisone injection, needling, or
arthroscopic calcium excision;
- type II may respond best to puncture aspiration;
- Flouroscopic Aspiration:
- under flouroscopic visualization needle is inserted into the deposit;
- confirmation of needle placement is established, when the needle remains
in the deposit as the arm is internally and externally rotated;
- lesion is alternatively injected w/ lidocaine and subsequently aspirated;
- Shoulder Arthroscopy:
- calcified lesion may lie within the tendon which does not allow its
visualization in the subacromial space;
- in this case flouroscopy may be used to help identify the lesion
(using a needle), and then
the arthroscopic shaver can be used to gently sweep away the
overlying bursa
which should allow exposure of the lesion;