Calcific tendinopathy of the rotator cuff in asymptomatic subjects

Very little is known on the prevalence of calcific tendinopathy in asymptomatic subjects and on the relationship between the presence of calcific deposits and the anatomo pathological characteristic of coracoacromial arch. Methods right-handed adult volunteers underwent x-ray examination of the right shoulder (true AP view in int/ext rot.;axillary view). We measured the acromiohumeral distance (AHD) and evaluated the acromion shape and the degenerative changes of the GH and AC joints. In the patients with calcific deposits, we measured the size of the deposits and classified the calcifications based on their location, shape and neatness. The subjects who had calcific deposits were clinically evaluated and underwent a second X-ray study after l4 months. Results 11 subjects (5%) had calcitication (9F). The latter was in thc substance of the supraspinatus tendon in 5 (mean age 45 yrs) and near cuff 0.3cm (avg). There were 3 insertion in 6 (66 yrs). The deposits measured 0.7 linear and 2 beanlike intratendinous calcifications and 5 linear and beanlike deposits near tendon insertion. All calcitications had well defined margins. AHD, acromion shape, arthritic of thc GH or AC joint were unrelated to the presence of calcifications. No subject showed evidence of cuff tear. lntratendinous deposit decreased in size in 2 cases and disappeared in 1. Conclusions 5% of asymptomatic subjects have calcitications. Supraspinatus tendon is most frequently involved. Calcifications are always small and wclhdetined. Morphology and pathologic changes of the coracoacromial arch or the GH or AC joint do not influence the deposition of calcium. Our study suggests that only well defined calciiications may cause pain and that they may decrease in size or disappear without completion of Uhthoff cycle.