Tendon calcification

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X-ray image of a calcareous shoulder
Classification according to ICD-10
M65.2 Tendinitis calcarea
M65.8 Other synovitis and tenosynovitis
M75.3 Tendinitis calcarea in the shoulder area
M77.9 Enthesopathy, unspecified
ICD-10 online (WHO version 2019)

The calcifying tendinitis (also calcific tendinitis or tendon calcification ) are calcareous deposits in tendons and tendons based. They occur particularly on the rotator cuff of the shoulder joint , also known as the calcified shoulder . The supraspinatus tendon is most frequently affected here. Other more frequent locations are e.g. B. patellar tendon , Achilles tendon and plantar fascia (see heel spur ) but in principle any other tendon can also be affected.

Chronic inflammatory or degenerative processes on the affected tendons ( tendopathy ) lead to remodeling processes in the tendon tissue, often accompanied by calcium deposits. Various processes trigger a remodeling or rupture ( tendon rupture ) at the location of the calcareous deposits, as a result of which inflammatory processes take place, which cause symptoms such as pain, swelling, reddening and restricted mobility.

The diagnosis is made through x-rays or sonography of the affected joint or the affected tendons.

Treatment is by giving anti-inflammatory drugs such as diclofenac or injections with steroids and local anesthetics . Successes with extracorporeal shock wave therapy (ESWT) are also described. The IGeL monitor of the MDS (Medical Service of the Central Association of Health Insurance Funds) rated extracorporeal shock wave therapy (ESWT) in the calcified shoulder as "unclear" after a systematic literature search. There is evidence of benefit but evidence of minor harm (e.g. pain during treatment, redness and bruising). Studies have shown that shock wave therapy reduces pain and improves arm mobility after unsuccessful conventional therapy, but no uniform statement can be made about how great this benefit is. The most important sources of the IGeL-Monitor are two review articles from 2014. If the conservative methods are unsuccessful , surgical removal - open surgical or arthroscopic - can lead to success.

See also

Web links

Individual evidence

  1. Alphabetical index for the ICD-10-WHO version 2019, volume 3. German Institute for Medical Documentation and Information (DIMDI), Cologne, 2019, p. 436
  2. IGeL-Monitor, evaluation of shock wave therapy in the calcified shoulder , accessed on April 29, 2019.
  3. Bannuru et al., High-energy extracorporeal shock-wave therapy for treating chronic calcific tendinitis of the shoulder: a systematic review. Annals of Internal Medicine 2014.160 (8): 542-549 and Louwerens et al., Evidence for minimally invasive therapies in the management of chronic calcific tendinopathy of the rotator cuff: a systematic review and meta-analysis. J Shoulder Elbow Surg. 2014 Aug; 23 (8): 1240-1249 . More on this in the report on the results of the IGeL monitor evaluation.