Calcific Tendinitis of the Shoulder: Calcium Deposits in the Rotator Cuff

Table of Contents

1. Calcium Crystals Inside a Living Tendon
2. Who Has Deposits in the Published Series
3. The Formative and Resorptive Phases
4. Why the Resorptive Phase Can Be So Painful
5. Diagnosis With X-Ray and Ultrasound
6. Complications Described in the Literature
7. Physiotherapy and Steroid Injection in the Trials
8. Needle Lavage Trial Results
9. Shockwave Therapy Trial Results
10. Surgery to Remove the Deposit
11. How Often Deposits Disappear on Their Own
12. What Is Not Known
13. Key Research Papers
14. Connections
15. Featured Videos

Calcium Crystals Inside a Living Tendon

The deposits in calcific tendinitis are made of apatite, the same family of calcium phosphate mineral that gives bone its hardness. A 2018 review from a French research group describes the deposits as “poorly crystalline carbonated apatite associated with protein”, and notes that among those proteins only osteopontin has been consistently identified as a possible regulator of the process (Darrieutort-Laffite 2018). Older textbooks often called the deposits an amorphous paste of hydroxyapatite.

A Swiss team looked at the deposits much more closely. In six people who had had shoulder pain for between 1 and 14 years, they removed calcium from the supraspinatus tendon during arthroscopy and examined it under a scanning electron microscope. The larger deposits, 1 to 20 micrometres across, turned out to be built from highly crystalline rods about 100 nanometres long and 20 nanometres wide. Chemical analysis found mainly calcium, oxygen and phosphorus, matching the composition of hydroxyapatite. Around the deposits were activated macrophages, the immune cells that clear debris (Mateos 2021). The authors proposed that when these aggregates break apart, the released needle-like nanocrystals may set off the strong inflammation many patients feel.

The process is not thought to be simple wear and tear. A review by Hans Uhthoff describes calcifying tendinitis as a reactive process carried out by living cells, not a dystrophic calcification of dead or degenerated tendon (Uhthoff 1996). Research from the 1990s found cells resembling cartilage cells around the deposits, inside a zone of fibrocartilage; more recently, tendon stem cells able to turn into such cells have been isolated, but how these cells start the mineralisation is still unclear (Darrieutort-Laffite 2018). One review from Egypt links the formative phase to brief periods of low oxygen in the tendon associated with repeated small injuries (ElShewy 2016); this is a proposed mechanism, not a proven one.

The supraspinatus, the tendon that runs over the top of the shoulder and helps lift the arm out to the side, is the tendon most often named in surgical and trial series. In an ultrasound survey of women from the general population, however, deposits were found about equally often in the supraspinatus (53.4% of affected shoulders) and the infraspinatus (54.6%), and a deposit located in the supraspinatus was one of the features linked to pain (Sansone 2016). More on the anatomy of the four cuff tendons is on the Rotator Cuff Injury page.

Back to Table of Contents

Who Has Deposits in the Published Series

Calcium deposits in the rotator cuff are common, and many cause no symptoms at all. Three published series give a picture of who has them:

• A Dutch radiology series of 1,219 adults. Deposits were found on X-ray in 57 of 734 people without shoulder pain (7.8%) and in 42.5% of 485 people with subacromial pain syndrome, the common painful-shoulder pattern under the bony roof of the shoulder. Age between 30 and 60 years (odds ratio 8.0), shoulder pain (odds ratio 7.1) and female sex (odds ratio 1.5) were linked to higher odds of a deposit. The authors concluded that women aged 30 to 60 with shoulder pain and a deposit longer than 1.5 cm had the highest chance of symptomatic calcific tendinitis (Louwerens 2015).
• An Italian ultrasound survey of 302 women (604 shoulders) attending a gynaecology clinic. Deposits were found in 17.8% of shoulders. Two-thirds of the shoulders with deposits (69 of 103) had no symptoms. Most deposits measured 2 to 5 mm (77.9%) and were linear in shape (69.9%). Pain was linked to deposits in more than one tendon, a supraspinatus location, older age and a high body mass index (Sansone 2016).
• A German cohort of 420 patients (488 shoulders) with long-standing painful calcific tendinitis. Sixty-four percent were women, the mean age was 51.3 years (range 28 to 84), and the condition was in one shoulder in 84% and in both shoulders in 16% (Ogon 2009).

Reviews give similar outlines. A German review describes the condition as affecting mainly people between 30 and 50 years of age (Rupp 2000); the Egyptian review places it in the fifth and sixth decades of life and among people with sedentary work (ElShewy 2016). Estimates of how many painful shoulders carry a deposit vary: the 2018 French review gives 10 to 42% of painful shoulders (Darrieutort-Laffite 2018), while a 2023 meta-analysis gives 7 to 17% of people with shoulder pain (Angileri 2023). A Japanese hospital series of 195 people with an acute attack, in which the deposit was breaking down, had a mean age of 62.6 years and found onsets most often in summer (35.4%) and least often in winter (15.9%); the authors state that the reason for this pattern is unclear (Furuhata 2020).

Back to Table of Contents

The Formative and Resorptive Phases

The most widely used description of the disease divides it into stages. The German review summarises them as a precalcific stage, a calcific stage made up of a formative phase, a resting period and a resorptive phase, and finally a postcalcific stage in which the tendon remodels back towards normal tissue (Rupp 2000). The same review adds a caution: the stages do not always follow this typical order, a painful deposit may persist, and pain can continue after the calcium has gone.

• Formative phase. Calcium is laid down and the deposit grows. According to the Egyptian review, this phase may last from one to six years and is usually painless (ElShewy 2016). On X-ray, a deposit in this phase tends to look dense, even and sharply outlined. Uhthoff described dense, homogeneous, well-delineated deposits as a sign that resorption has not yet begun (Uhthoff 1996).
• Resting period. The deposit is present but neither growing nor being removed.
• Resorptive phase. The body starts to remove the calcium. Small blood vessels grow in at the edge of the deposit, and macrophages and giant cells move in to break it down. The same review puts this phase at three weeks to six months (ElShewy 2016).
• Postcalcific stage. The space left by the deposit fills with new tendon tissue.

Trial teams often grade the X-ray appearance of deposits with the Gärtner classification, types I to III. Types I and II are the sharply outlined, densely structured deposits; type III deposits were the ones linked to a better outcome without surgery in a large German cohort (Ogon 2009). In one comparison of surgery and shockwave therapy, only Gärtner types I and II were enrolled, specifically to keep the chance of spontaneous resorption low (Rebuzzi 2008).

Back to Table of Contents

Why the Resorptive Phase Can Be So Painful

The odd feature of calcific tendinitis is that the worst pain often comes as the deposit is being cleared. The Egyptian review describes the resorptive phase as an aggressive inflammatory reaction with swelling and a rise in pressure inside the tendon, resulting in a severely painful shoulder (ElShewy 2016). The same review notes that the pain at this stage can be so intolerable that patients often ask for any procedure that will stop it.

Several mechanisms have been described. The 2018 French review reports that during spontaneous resorption, apatite crystals can migrate out of the tendon into the subacromial bursa, the fluid-filled cushion that sits above it, causing severe pain and restricted movement. In laboratory experiments, in cells and in animals, apatite crystals drew in white blood cells and triggered the release of the inflammatory signals interleukin-1 beta and interleukin-18 through a cell sensor called the NLRP3 inflammasome (Darrieutort-Laffite 2018). The Swiss microscopy work adds that the crystals are rod-like and that macrophages surround them, and its authors suggest that fragmentation of large aggregates into nanocrystals may be what starts the strong reaction (Mateos 2021). A 2013 review from the United States describes resorption as being associated with an acute inflammatory response that is often what prompts a person to seek medical care (Carcia 2013).

A practical point follows from this. Because sudden severe pain can mean the deposit is already breaking down, several reviews describe the resorptive phase as a time when surgery is postponed: Uhthoff advised postponing any decision about surgery when there is evidence of ongoing resorption, since only exceptionally will natural resorption not occur (Uhthoff 1996), and the German review describes a conservative approach during the resorption phase (Rupp 2000). These are the authors' clinical views, not trial results.

Back to Table of Contents

Diagnosis With X-Ray and Ultrasound

Plain X-ray. Tendons do not show on an ordinary X-ray, but calcium does. A deposit appears as a white patch above the head of the upper arm bone, and the X-ray also shows its size, its shape (dense or cloudy) and roughly which tendon it sits in. Most of the trials on this page used X-rays to measure deposit size before and after treatment. The Egyptian review states that routine X-ray detects the deposits and helps suggest the phase of the disease (ElShewy 2016).

Ultrasound. Ultrasound shows the deposit inside the tendon, its size and shape, whether it casts an acoustic shadow (a dark band behind a hard deposit), the state of the rest of the tendon and the bursa, and whether there is increased blood flow on Doppler imaging. The Italian survey found most of its deposits with high-resolution ultrasound, many of them small and linear (Sansone 2016). Ultrasound is also used to guide needles in lavage and injection trials. The German review describes judging the stage of the disease by combining the pain history, the look of the deposit on X-ray and the ultrasound findings (Rupp 2000).

Features linked to outcome. In the German cohort of 420 patients, deposits that were cloudy on X-ray (Gärtner type III) and deposits that cast no acoustic shadow on ultrasound were linked to a better result without surgery. Deposits in both shoulders, deposits lying under the front of the acromion, deposits extending inward under the acromion and large deposits were linked to failure of non-operative treatment (Ogon 2009).

Magnetic resonance imaging (MRI). According to the Egyptian review, MRI gives a better look at other problems in the same shoulder, such as a tendon tear (ElShewy 2016). An X-ray of the shoulder, alongside the other tests used for a painful shoulder, is described on the Shoulder Pain page.

Back to Table of Contents

Complications Described in the Literature

An Italian review that gathered the published reports lists five main complications of calcific tendinitis: persistent pain, adhesive capsulitis (frozen shoulder), rotator cuff tears, osteolysis (thinning or erosion) of the greater tuberosity of the upper arm bone where the tendon attaches, and ossifying tendinitis, in which true bone forms in the tendon (Merolla 2015). The same review states that the condition remains without symptoms in the majority of people who have deposits, and that the literature on complications is limited.

Back to Table of Contents

Physiotherapy and Steroid Injection in the Trials

Physiotherapy and exercise. Exercise is usually part of every treatment arm rather than a treatment tested on its own. In the largest sham-controlled trial of needle lavage (described in the next section), all 220 participants received a programme of four home exercises (Moosmayer 2023). In two Norwegian trials of radial shockwave therapy, every participant also received supervised exercises (Kvalvaag 2017; Kvalvaag 2018). None of the abstracts read for this page reports a trial of physiotherapy alone against no treatment in people with calcific deposits, so how much of the improvement in these trials comes from exercise is not measured.

Steroid injection into the bursa. A steroid injection into the subacromial bursa (the cushion above the cuff) is the usual comparison treatment in the lavage trials:

• In the Norwegian and Swedish sham-controlled trial, one arm received sham lavage plus an injection of triamcinolone acetonide (the trial gave 20 mg with 9 mL of 1% lidocaine) and another received sham lavage with lidocaine only. At four months the steroid arm was not significantly better than sham on the Oxford Shoulder Score (difference 2.0 points on a 48-point scale), and at 24 months no study procedure was better than sham (Moosmayer 2023).
• In a French trial of 132 people who had all just had needle lavage, a steroid injection (the trial gave methylprednisolone 40 mg) was compared with saline. Saline could not be shown to be as good as steroid for pain in the first week. The steroid group had less pain at rest and on activity for six weeks and better function for three months. Steroid did not change how often the calcium disappeared: resorption at 12 months was 74% with steroid and 83% with saline (Darrieutort-Laffite 2019).
• In a Turkish double-blind trial of 31 people followed for only one month, steroid injection alone and steroid injection plus lavage both improved shoulder scores, with no difference between the groups; only the lavage group showed a significant fall in resting pain and in deposit size on ultrasound (Yıldıran 2026).

How a steroid injection compares with lavage over one and five years is covered in the Dutch trial below (de Witte 2013; de Witte 2017).

Back to Table of Contents

Needle Lavage Trial Results

Ultrasound-guided needle lavage, also called barbotage or needling, uses one or two needles placed into the deposit under ultrasound. Fluid is pushed in and drawn back repeatedly to break up the calcium and wash some of it out. It is usually followed by a steroid injection into the bursa. The trials give mixed results, and the largest one is negative.

Dutch trial: lavage plus steroid versus steroid alone (48 patients).

• At one year: the mean Constant shoulder score (0 to 100, higher is better) was 86.0 in the lavage group and 73.9 in the steroid-only group (P = .005). Deposits shrank by 11.6 mm with lavage and 5.1 mm with steroid alone. Total resorption occurred in 13 and 6 patients (P = .07). Four lavage patients and 11 steroid-only patients needed a further lavage or surgery (de Witte 2013).
• At five years: the mean Constant score was 90 versus 87, and the difference was no longer significant. Total resorption was 62% in the lavage group and 73% in the steroid-only group (P = .45). Additional treatment during follow-up was needed by 4 lavage patients and 16 steroid-only patients (P < .001) (de Witte 2017).

Norwegian and Swedish sham-controlled trial (220 patients). This pragmatic, double-blind trial at six hospitals compared lavage plus steroid, sham lavage plus steroid, and sham lavage with local anaesthetic only, all with home exercises. At four months the difference between lavage plus steroid and sham was 0.2 points on the 48-point Oxford Shoulder Score, which was not significant. After four months, 143 patients whose results were not good enough received supplementary treatment. At 24 months none of the study procedures was better than sham, and no serious adverse events were reported (Moosmayer 2023). This is the only lavage trial in this list with a sham procedure, and it found no benefit.

French steroid-or-saline trial (132 patients). All patients had lavage of a deposit larger than 5 mm. Calcium disappeared in 74 to 83% by 12 months (Darrieutort-Laffite 2019). A later analysis of the same patients found that actually drawing calcium out during the procedure (odds ratio 10.7) was linked to a good result at six months, that making an opening between the deposit and the bursa was linked to the deposit disappearing, and that disappearance of the calcium went together with a good clinical result at every time point (Dumoulin 2021). Because this analysis was not randomised, it shows associations, not cause and effect.

Lavage versus shockwave therapy. A Dutch trial comparing lavage with high-energy shockwave therapy is described in the next section (Louwerens 2020; van Noort 2026).

Back to Table of Contents

Shockwave Therapy Trial Results

Extracorporeal shockwave therapy sends short, high-pressure sound pulses through the skin into the deposit. Focused machines aim the energy at a small target; radial machines spread lower energy over a wider area. Treatment is given in several sessions, and the energy dose varies widely between studies.

German and Austrian placebo-controlled trial (144 patients). In this double-blind trial, people with chronic calcific tendinitis received high-energy shockwave therapy, low-energy shockwave therapy at the same total energy, or a sham treatment, in two sessions about two weeks apart followed by physical therapy. At six months the Constant-Murley score had improved by 31.0 points with high energy, 15.0 points with low energy and 6.6 points with sham (P < .001 for both active groups against sham). High energy was also better than low energy. The results for pain and for shrinkage of the deposits at 3, 6 and 12 months went the same way (Gerdesmeyer 2003).

Dutch trial: shockwave versus needle lavage (82 patients). People whose symptoms had not settled with conservative treatment received either four sessions of high-energy focused shockwave therapy (the trial gave 2,000 pulses at an energy flux density of 0.35 mJ/mm²) or ultrasound-guided needling with a steroid injection into the bursa.

• At one year: the improvement in Constant-Murley score was 20.9 points after needling and 15.7 after shockwave therapy (P = .23), with similar changes in disability and pain scores. The deposit shrank by 13 mm after needling and 6.7 mm after shockwave therapy (P < .001). Additional treatment for persistent symptoms was needed by 22% of the needling group and 41% of the shockwave group (Louwerens 2020).
• At five years or more (mean 6.8 years, 67 of the 82 patients): the mean Constant-Murley score was 94.4 after shockwave therapy and 93.3 after needling (P = .67), and 94% of both groups had improved by at least the minimal clinically important difference. Additional treatment had been received by 42% of the shockwave group and 26% of the needling group (P = .17). No deposit came back in a treated tendon, but new deposits in a different rotator cuff tendon were seen in 15% of the needling patients (van Noort 2026).

Norwegian trials of radial shockwave therapy (143 patients). People with subacromial shoulder pain, with or without calcium, received radial shockwave therapy or a sham, both with supervised exercises. At 24 weeks there was no difference overall; in a pre-planned subgroup with calcium in the cuff, the shockwave group improved more on the Shoulder Pain and Disability Index (mean difference 12.8 points) (Kvalvaag 2017). At one year that subgroup difference (6.3 points) was no longer significant (Kvalvaag 2018).

Cochrane review (2020). The review included 32 trials with 2,281 participants; 25 trials enrolled people with calcific deposits. Against placebo, at three months, shockwave therapy reduced pain by 0.78 points on a 0 to 10 scale (the review took 1.5 points as clinically important) and improved function by 7.9 points on a 0 to 100 scale (10 points taken as clinically important), both from moderate-certainty evidence. Adverse events were reported by 41 of 156 people after shockwave therapy and 10 of 139 after placebo (low-certainty evidence). Subgroup analyses found no difference in results between people with and without calcific deposits. The authors concluded that there were very few clinically important benefits and uncertainty about safety, while noting that differing doses mean some trials may have tested too low a dose (Surace 2020).

Back to Table of Contents

Surgery to Remove the Deposit

Surgery, now usually done by arthroscopy (keyhole surgery), opens the tendon over the deposit and removes the calcium. The German review describes it as the step for people whose pain persists after conservative care and after shockwave therapy or needling (Rupp 2000), and much of the evidence comes from case series rather than randomised trials.

• French multicentre series (112 patients). Arthroscopic treatment of chronic calcifying tendinitis gave an objective success rate of 89% and patient satisfaction of 82%; 88% had complete disappearance of the deposit on follow-up X-rays, with no recurrences. Results were better when the calcium was removed than when it was left in place, and adding acromioplasty (shaving bone from the underside of the acromion) did not improve results. The authors wrote that great care is needed in deciding on surgery because of the high rate of spontaneous resorption (Molé 1993).
• Italian comparison of arthroscopy and low-energy shockwave therapy (46 patients, retrospective). At two years, 81.81% of the surgery group and 70.83% of the shockwave group reported good or excellent results, with no significant difference in scores; deposits had disappeared in 86.35% and 58.33% (Rebuzzi 2008). This was not a randomised trial.
• 2023 meta-analysis (27 studies, 2,212 non-operative and 140 operative patients). The pooled improvement in Constant-Murley score was 38.35 points after surgery, 22.01 after needling and 18.30 after shockwave therapy; pain fell by 4.65, 4.83 and 3.83 points on a 0 to 10 scale. Complete radiographic resolution was reported in 85% of operative and 67% of needling patients. The authors state that high-quality trials comparing surgery and non-operative treatment directly, before other treatment has failed, are still needed (Angileri 2023).

Pooled numbers like these come from different groups of patients at different stages of disease, so they do not show that one treatment caused a bigger improvement than another. Removing bone under the acromion for other kinds of shoulder pain is discussed on the Rotator Cuff Injury page.

Back to Table of Contents

How Often Deposits Disappear on Their Own

Almost every review says that calcium deposits in the rotator cuff tend to disappear on their own. The German review describes “a strong tendency towards self-healing by spontaneous resorption of the deposit” (Rupp 2000). Uhthoff wrote that only exceptionally will natural resorption not occur (Uhthoff 1996). The Egyptian review states that the natural history ends with resorption and complete relief of pain (ElShewy 2016). The French arthroscopy group warned of a high rate of spontaneous resorption (Molé 1993), and the 2013 review from the United States states that the majority of cases need nothing more than symptomatic care and “benign neglect” (Carcia 2013).

Turning that into a number is harder. None of the abstracts read for this page reports a modern cohort of untreated people with repeated X-rays that gives a resorption rate. The closest figures come from trials and cohorts:

• In the Dutch trial, the group that received only a steroid injection (no needling) had total resorption in 6 of 25 patients at one year and in 73% at five years; 16 of that group had received additional treatment along the way, so this is not a pure natural course (de Witte 2013; de Witte 2017).
• In the French trial, calcium had disappeared by 12 months in 83% of patients after lavage with saline and 74% after lavage with steroid (Darrieutort-Laffite 2019).
• In the German cohort of people with long-standing painful deposits (mean 4.4 years of non-operative care before referral), non-operative treatment failed in 114 of 420 patients (27%) after at least six more months, meaning about three in four did not go on to fail it (Ogon 2009).
• In the 220-patient trial, people who received only a sham procedure with exercises did no worse than those who had lavage or steroid, at both four and 24 months (Moosmayer 2023).

The deposit and the pain do not always go together. The Italian survey found deposits in many shoulders that had no symptoms (Sansone 2016), and the German review notes that pain can persist after the calcium has gone (Rupp 2000).

Back to Table of Contents

What Is Not Known

• Why deposits form. The cells and signals that start mineralisation inside a living tendon are still largely unknown, and the mechanisms that end the inflammation and clear the deposit still need to be worked out (Darrieutort-Laffite 2018).
• How often deposits resolve without treatment, and how fast. The statements in reviews are firm, but the abstracts read here give no modern untreated cohort with a measured rate.
• Whether lavage beats a sham. The smaller Dutch trial favoured lavage at one year, but the difference had gone by five years, and the larger sham-controlled trial found no benefit at four or 24 months (de Witte 2013; de Witte 2017; Moosmayer 2023).
• The right shockwave dose. High energy beat low energy and sham in one placebo-controlled trial (Gerdesmeyer 2003), while the Cochrane review found small average effects and could not rule out that some trials used too little energy (Surace 2020).
• Surgery against non-operative care. No randomised trial in the abstracts read compares surgery directly with lavage or shockwave therapy before other treatments have been tried (Angileri 2023).
• Why some people have pain and others do not. Most deposits found in a general-population survey caused no symptoms (Sansone 2016), and seasonal patterns in acute attacks remain unexplained (Furuhata 2020).

Decisions about injections, procedures and surgery belong with a clinician who has seen the shoulder and its images.

Back to Table of Contents

Key Research Papers

1. Louwerens JKG, Sierevelt IN, Kramer ET, Boonstra R, van den Bekerom MPJ, van Royen BJ, Eygendaal D, van Noort A. Comparing Ultrasound-Guided Needling Combined With a Subacromial Corticosteroid Injection Versus High-Energy Extracorporeal Shockwave Therapy for Calcific Tendinitis of the Rotator Cuff: A Randomized Controlled Trial. Arthroscopy. 2020;36(7):1823-1833.e1. PubMed PMID: 32114063
2. van Noort DM, Louwerens JKG, Sierevelt IN, van Noort A. Comparable Midterm Outcomes for Ultrasound-Guided Needling Versus High-Energy Shockwave Therapy for Rotator Cuff Calcific Tendinitis: A Randomized Controlled Trial. Arthroscopy. 2026;42(11):2485-2493. PubMed PMID: 42496014
3. Yıldıran NT, Çakır B, Özekli Mısırlıoğlu T, Terlemez R, Akgün K, Palamar D. Comparison of Ultrasound-Guided Lavage and Subacromial Bursa Injection for Calcific Tendinitis: A Prospective, Randomized, Double-Blind Trial. Arch Phys Med Rehabil. 2026;107(11):3171-3179. PubMed PMID: 42364757
4. de Witte PB, Selten JW, Navas A, Nagels J, Visser CP, Nelissen RG, Reijnierse M. Calcific tendinitis of the rotator cuff: a randomized controlled trial of ultrasound-guided needling and lavage versus subacromial corticosteroids. Am J Sports Med. 2013;41(7):1665-73. PubMed PMID: 23696211
5. de Witte PB, Kolk A, Overes F, Nelissen RGHH, Reijnierse M. Rotator Cuff Calcific Tendinitis: Ultrasound-Guided Needling and Lavage Versus Subacromial Corticosteroids: Five-Year Outcomes of a Randomized Controlled Trial. Am J Sports Med. 2017;45(14):3305-3314. PubMed PMID: 28898104
6. Moosmayer S, Ekeberg OM, Hallgren HB, Heier I, Kvalheim S, Juel NG, Blomquist J, Pripp AH, Brox JI. Ultrasound guided lavage with corticosteroid injection versus sham lavage with and without corticosteroid injection for calcific tendinopathy of shoulder: randomised double blinded multi-arm study. BMJ. 2023;383:e076447. PubMed PMID: 37821122
7. Darrieutort-Laffite C, Varin S, Coiffier G, Albert JD, Planche L, Maugars Y, Cormier G, Le Goff B. Are corticosteroid injections needed after needling and lavage of calcific tendinitis? Randomised, double-blind, non-inferiority trial. Ann Rheum Dis. 2019;78(6):837-843. PubMed PMID: 30975645
8. Dumoulin N, Cormier G, Varin S, Coiffier G, Albert JD, Le Goff B, Darrieutort-Laffite C. Factors Associated With Clinical Improvement and the Disappearance of Calcifications After Ultrasound-Guided Percutaneous Lavage of Rotator Cuff Calcific Tendinopathy: A Post Hoc Analysis of a Randomized Controlled Trial. Am J Sports Med. 2021;49(4):883-891. PubMed PMID: 33719606
9. Gerdesmeyer L, Wagenpfeil S, Haake M, Maier M, Loew M, Wörtler K, Lampe R, Seil R, Handle G, Gassel S, Rompe JD. Extracorporeal shock wave therapy for the treatment of chronic calcifying tendonitis of the rotator cuff: a randomized controlled trial. JAMA. 2003;290(19):2573-80. PubMed PMID: 14625334
10. Kvalvaag E, Brox JI, Engebretsen KB, Soberg HL, Juel NG, Bautz-Holter E, Sandvik L, Roe C. Effectiveness of Radial Extracorporeal Shock Wave Therapy (rESWT) When Combined With Supervised Exercises in Patients With Subacromial Shoulder Pain: A Double-Masked, Randomized, Sham-Controlled Trial. Am J Sports Med. 2017;45(11):2547-2554. PubMed PMID: 28586628
11. Kvalvaag E, Roe C, Engebretsen KB, Soberg HL, Juel NG, Bautz-Holter E, Sandvik L, Brox JI. One year results of a randomized controlled trial on radial Extracorporeal Shock Wave Treatment, with predictors of pain, disability and return to work in patients with subacromial pain syndrome. Eur J Phys Rehabil Med. 2018;54(3):341-350. PubMed PMID: 28655271
12. Surace SJ, Deitch J, Johnston RV, Buchbinder R. Shock wave therapy for rotator cuff disease with or without calcification. Cochrane Database Syst Rev. 2020;3(3):CD008962. PubMed PMID: 32128761
13. Angileri HS, Gohal C, Comeau-Gauthier M, Owen MM, Shanmugaraj A, Terry MA, Tjong VK, Khan M. Chronic calcific tendonitis of the rotator cuff: a systematic review and meta-analysis of randomized controlled trials comparing operative and nonoperative interventions. J Shoulder Elbow Surg. 2023;32(8):1746-1760. PubMed PMID: 37080421
14. Rebuzzi E, Coletti N, Schiavetti S, Giusto F. Arthroscopy surgery versus shock wave therapy for chronic calcifying tendinitis of the shoulder. J Orthop Traumatol. 2008;9(4):179-85. PubMed PMID: 19384483
15. Molé D, Kempf JF, Gleyze P, Rio B, Bonnomet F, Walch G. [Results of endoscopic treatment of non-broken tendinopathies of the rotator cuff. 2. Calcifications of the rotator cuff]. Rev Chir Orthop Reparatrice Appar Mot. 1993;79(7):532-41. PubMed PMID: 8085035
16. Louwerens JK, Sierevelt IN, van Hove RP, van den Bekerom MP, van Noort A. Prevalence of calcific deposits within the rotator cuff tendons in adults with and without subacromial pain syndrome: clinical and radiologic analysis of 1219 patients. J Shoulder Elbow Surg. 2015;24(10):1588-93. PubMed PMID: 25870115
17. Sansone V, Consonni O, Maiorano E, Meroni R, Goddi A. Calcific tendinopathy of the rotator cuff: the correlation between pain and imaging features in symptomatic and asymptomatic female shoulders. Skeletal Radiol. 2016;45(1):49-55. PubMed PMID: 26306389
18. Ogon P, Suedkamp NP, Jaeger M, Izadpanah K, Koestler W, Maier D. Prognostic factors in nonoperative therapy for chronic symptomatic calcific tendinitis of the shoulder. Arthritis Rheum. 2009;60(10):2978-84. PubMed PMID: 19790063
19. Furuhata R, Matsumura N, Yoshiyama A, Kamata Y, Takahashi M, Morioka H. Seasonal variation in the onset of acute calcific tendinitis of rotator cuff. BMC Musculoskelet Disord. 2020;21(1):741. PubMed PMID: 33183291
20. Mateos JM, Singer G, Kaech A, Ziegler U, Eid K. Characterization of Deposits in Calcific Tendinitis of the Shoulder: Deposits Are Composed of Large Aggregates of Highly Crystalline, Rod-Like Crystals. Orthop J Sports Med. 2021;9(10):23259671211044715. PubMed PMID: 34660828
21. Darrieutort-Laffite C, Blanchard F, Le Goff B. Calcific tendonitis of the rotator cuff: From formation to resorption. Joint Bone Spine. 2018;85(6):687-692. PubMed PMID: 29195923
22. ElShewy MT. Calcific tendinitis of the rotator cuff. World J Orthop. 2016;7(1):55-60. PubMed PMID: 26807357
23. Uhthoff HK. Calcifying tendinitis. Ann Chir Gynaecol. 1996;85(2):111-5. PubMed PMID: 8817047
24. Rupp S, Seil R, Kohn D. [Tendinosis calcarea of the rotator cuff]. Orthopade. 2000;29(10):852-67. PubMed PMID: 11142905
25. Carcia CR, Scibek JS. Causation and management of calcific tendonitis and periarthritis. Curr Opin Rheumatol. 2013;25(2):204-9. PubMed PMID: 23370373
26. Merolla G, Bhat MG, Paladini P, Porcellini G. Complications of calcific tendinitis of the shoulder: a concise review. J Orthop Traumatol. 2015;16(3):175-83. PubMed PMID: 25697847

PubMed Topic Searches

1. PubMed: needle lavage (barbotage) trials in calcific tendinitis
2. PubMed: shockwave therapy trials in calcific tendinitis
3. PubMed: spontaneous resorption of rotator cuff calcium deposits
4. PubMed: arthroscopic removal of calcium deposits

Back to Table of Contents

Connections

• Orthopedics — the parent category for bone, joint and tendon conditions
• Shoulder Pain — the wider list of causes of a painful shoulder
• Rotator Cuff Injury — the four cuff tendons and their injuries
• Rotator Cuff Tear — one of the complications listed for calcific tendinitis
• Frozen Shoulder — adhesive capsulitis, another listed complication
• Tendinitis — tendon inflammation throughout the body
• Bursitis — inflammation of the cushion the crystals can spill into

Back to Table of Contents

Featured Videos