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Erschienen in: Skeletal Radiology 6/2023

12.10.2022 | Case Report

Chronic intramuscular calcific tendinitis of the deltoid muscle

verfasst von: Yuki Yoshida, Atsushi Yoshida

Erschienen in: Skeletal Radiology | Ausgabe 6/2023

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Abstract

Calcific tendinitis is a potentially symptomatic disorder characterized by calcium deposits in the substance of the tendon. Although this condition can occur in any tendinous tissue throughout the human body, calcium deposition commonly occurs at tendon insertions near the bone–tendon junction. The musculotendinous junction of the deltoid muscle has peculiarly dense intramuscular tendons to which muscle fibers attach obliquely to create muscular strength. Given that the intramuscular tendons themselves, which form the consecutive part from the insertion, are subjected to unpredictable stress load or microtrauma similar to tendon insertions, it is reasonable to assume that calcific tendinitis could also occur at the intramuscular tendons. Here we report a case of chronic symptomatic calcium deposition in the lateral part of the deltoid muscle between the origin and the insertion, which was eventually surgically removed and confirmed as intramuscular calcific tendinitis.
Literatur
1.
Zurück zum Zitat Depalma AF, Kruper JS. Long-term study of shoulder joints afflicted with and treated for calcific tendinitis. Clin Orthop. 1961;20:61–72.PubMed Depalma AF, Kruper JS. Long-term study of shoulder joints afflicted with and treated for calcific tendinitis. Clin Orthop. 1961;20:61–72.PubMed
4.
Zurück zum Zitat Albano D, Coppola A, Gitto S, Rapisarda S, Messina C, Sconfienza LM. Imaging of calcific tendinopathy around the shoulder: usual and unusual presentations and common pitfalls. Radiol Med. 2021;126(4):608–19.CrossRefPubMed Albano D, Coppola A, Gitto S, Rapisarda S, Messina C, Sconfienza LM. Imaging of calcific tendinopathy around the shoulder: usual and unusual presentations and common pitfalls. Radiol Med. 2021;126(4):608–19.CrossRefPubMed
5.
Zurück zum Zitat Merolla G, Singh S, Paladini P, Porcellini G. Calcific tendinitis of the rotator cuff: state of the art in diagnosis and treatment. J Orthop Traumatol. 2016;17(1):7–14.CrossRefPubMed Merolla G, Singh S, Paladini P, Porcellini G. Calcific tendinitis of the rotator cuff: state of the art in diagnosis and treatment. J Orthop Traumatol. 2016;17(1):7–14.CrossRefPubMed
6.
Zurück zum Zitat Hayes CW, Conway WF. Calcium hydroxyapatite deposition disease. Radiographics. 1990;10(6):1031–48.CrossRefPubMed Hayes CW, Conway WF. Calcium hydroxyapatite deposition disease. Radiographics. 1990;10(6):1031–48.CrossRefPubMed
7.
Zurück zum Zitat Becciolini M, Bonacchi G, Galletti S. Intramuscular migration of calcific tendinopathy in the rotator cuff: ultrasound appearance and a review of the literature. J Ultrasound. 2016;19(3):175–81.CrossRefPubMedPubMedCentral Becciolini M, Bonacchi G, Galletti S. Intramuscular migration of calcific tendinopathy in the rotator cuff: ultrasound appearance and a review of the literature. J Ultrasound. 2016;19(3):175–81.CrossRefPubMedPubMedCentral
9.
Zurück zum Zitat Pereira BPG, Chang EY, Resnick DL, Pathria MN. Intramuscular migration of calcium hydroxyapatite crystal deposits involving the rotator cuff tendons of the shoulder: report of 11 patients. Skelet Radiol. 2016;45(1):97–103.CrossRef Pereira BPG, Chang EY, Resnick DL, Pathria MN. Intramuscular migration of calcium hydroxyapatite crystal deposits involving the rotator cuff tendons of the shoulder: report of 11 patients. Skelet Radiol. 2016;45(1):97–103.CrossRef
10.
Zurück zum Zitat Stirma GA, Chaves DH, Belangero PS, Andreoli CV, de Castro Pochini AC, Ejnisman B. Arthroscopic treatment of an unusual intramuscular calcium hydroxyapatite crystal deposit on the rotator cuff. Arthrosc Tech. 2019;8(10):e1093–7.CrossRefPubMedPubMedCentral Stirma GA, Chaves DH, Belangero PS, Andreoli CV, de Castro Pochini AC, Ejnisman B. Arthroscopic treatment of an unusual intramuscular calcium hydroxyapatite crystal deposit on the rotator cuff. Arthrosc Tech. 2019;8(10):e1093–7.CrossRefPubMedPubMedCentral
11.
Zurück zum Zitat Kachewar SG, Kulkarni DS. Calcific tendinitis of the rotator cuff: a review. J Clin Diagn Res. 2013;7(7):1482–5.PubMedPubMedCentral Kachewar SG, Kulkarni DS. Calcific tendinitis of the rotator cuff: a review. J Clin Diagn Res. 2013;7(7):1482–5.PubMedPubMedCentral
12.
Zurück zum Zitat Louwerens JKG, Veltman ES, van Noort A, van den Bekerom MPJ. The effectiveness of high-energy extracorporeal shockwave therapy versus ultrasound-guided needling versus arthroscopic surgery in the management of chronic calcific rotator cuff tendinopathy: a systematic review. Arthroscopy. 2016;32(1):165–75.CrossRefPubMed Louwerens JKG, Veltman ES, van Noort A, van den Bekerom MPJ. The effectiveness of high-energy extracorporeal shockwave therapy versus ultrasound-guided needling versus arthroscopic surgery in the management of chronic calcific rotator cuff tendinopathy: a systematic review. Arthroscopy. 2016;32(1):165–75.CrossRefPubMed
13.
Zurück zum Zitat Suzuki K, Potts A, Anakwenze O, Singh A. Calcific tendinitis of the rotator cuff: management options. J Am Acad Orthop Surg. 2014;22(11):707–17.CrossRefPubMed Suzuki K, Potts A, Anakwenze O, Singh A. Calcific tendinitis of the rotator cuff: management options. J Am Acad Orthop Surg. 2014;22(11):707–17.CrossRefPubMed
14.
Zurück zum Zitat Moser T, Lecours J, Michaud J, Bureau NJ, Guillin R, Cardinal É. The deltoid, a forgotten muscle of the shoulder. Skelet Radiol. 2013;42(10):1361–75.CrossRef Moser T, Lecours J, Michaud J, Bureau NJ, Guillin R, Cardinal É. The deltoid, a forgotten muscle of the shoulder. Skelet Radiol. 2013;42(10):1361–75.CrossRef
15.
Zurück zum Zitat Goldman AB. Calcific tendinitis of the long head of the biceps brachii distal to the glenohumeral joint: plain film radiographic findings. AJR Am J Roentgenol. 1989;153(5):1011–6.CrossRefPubMed Goldman AB. Calcific tendinitis of the long head of the biceps brachii distal to the glenohumeral joint: plain film radiographic findings. AJR Am J Roentgenol. 1989;153(5):1011–6.CrossRefPubMed
16.
Zurück zum Zitat Almedghio S, Garneti N. The acute and chronic presentation of gluteus medius calcific tendinitis- a case report of two. J Orthop Case Rep. 2014;4(4):48–50.PubMedPubMedCentral Almedghio S, Garneti N. The acute and chronic presentation of gluteus medius calcific tendinitis- a case report of two. J Orthop Case Rep. 2014;4(4):48–50.PubMedPubMedCentral
17.
Zurück zum Zitat Park SY, Jin W, Lee SH, Park JS, Yang DM, Ryu KN. Acute retropharyngeal calcific tendinitis: a case report with unusual location of calcification. Skeletal Radiol. 2010;39(8):817–20.CrossRefPubMed Park SY, Jin W, Lee SH, Park JS, Yang DM, Ryu KN. Acute retropharyngeal calcific tendinitis: a case report with unusual location of calcification. Skeletal Radiol. 2010;39(8):817–20.CrossRefPubMed
18.
Zurück zum Zitat Williams AA, Stang TS, Fritz J, Papp DF. Calcific tendinitis of the gluteus maximus in a golfer. Orthopedics. 2016;39(5):e997-1000.CrossRefPubMed Williams AA, Stang TS, Fritz J, Papp DF. Calcific tendinitis of the gluteus maximus in a golfer. Orthopedics. 2016;39(5):e997-1000.CrossRefPubMed
19.
Zurück zum Zitat Uhthoff HK, Sarkar K, Maynard JA. Calcifying tendinitis: a new concept of its pathogenesis. Clin Orthop Relat Res. 1976;118(118):164–8. Uhthoff HK, Sarkar K, Maynard JA. Calcifying tendinitis: a new concept of its pathogenesis. Clin Orthop Relat Res. 1976;118(118):164–8.
20.
Zurück zum Zitat Vidavsky N, Kunitake J, Estroff LA. Multiple pathways for pathological calcification in the human body. Adv Healthc Mater. 2021;10(4): e2001271.CrossRefPubMed Vidavsky N, Kunitake J, Estroff LA. Multiple pathways for pathological calcification in the human body. Adv Healthc Mater. 2021;10(4): e2001271.CrossRefPubMed
21.
Zurück zum Zitat Brukner P, Cook JL, Purdam CR. Does the intramuscular tendon act like a free tendon? Br J Sports Med. 2018;52(19):1227–8.CrossRefPubMed Brukner P, Cook JL, Purdam CR. Does the intramuscular tendon act like a free tendon? Br J Sports Med. 2018;52(19):1227–8.CrossRefPubMed
22.
Zurück zum Zitat Lorne E, Gagey O, Quillard J, Hue E, Gagey N. The fibrous frame of the deltoid muscle. Its functional and surgical relevance. Clin Orthop Relat Res. 2001;386(386):222–5.CrossRef Lorne E, Gagey O, Quillard J, Hue E, Gagey N. The fibrous frame of the deltoid muscle. Its functional and surgical relevance. Clin Orthop Relat Res. 2001;386(386):222–5.CrossRef
23.
Zurück zum Zitat Brukner P, Connell D. “Serious thigh muscle strains”: beware the intramuscular tendon which plays an important role in difficult hamstring and quadriceps muscle strains. Br J Sports Med. 2016;50(4):205–8.CrossRefPubMed Brukner P, Connell D. “Serious thigh muscle strains”: beware the intramuscular tendon which plays an important role in difficult hamstring and quadriceps muscle strains. Br J Sports Med. 2016;50(4):205–8.CrossRefPubMed
24.
Zurück zum Zitat Garrett WE Jr, Nikolaou PK, Ribbeck BM, Glisson RR, Seaber AV. The effect of muscle architecture on the biomechanical failure properties of skeletal muscle under passive extension. Am J Sports Med. 1988;16(1):7–12.CrossRefPubMed Garrett WE Jr, Nikolaou PK, Ribbeck BM, Glisson RR, Seaber AV. The effect of muscle architecture on the biomechanical failure properties of skeletal muscle under passive extension. Am J Sports Med. 1988;16(1):7–12.CrossRefPubMed
25.
Zurück zum Zitat Archambault JM, Jelinsky SA, Lake SP, Hill AA, Glaser DL, Soslowsky LJ. Rat supraspinatus tendon expresses cartilage markers with overuse. J Orthop Res. 2007;25(5):617–24.CrossRefPubMed Archambault JM, Jelinsky SA, Lake SP, Hill AA, Glaser DL, Soslowsky LJ. Rat supraspinatus tendon expresses cartilage markers with overuse. J Orthop Res. 2007;25(5):617–24.CrossRefPubMed
26.
Zurück zum Zitat Cho NS, Lee BG, Rhee YG. Radiologic course of the calcific deposits in calcific tendinitis of the shoulder: does the initial radiologic aspect affect the final results? J Shoulder Elbow Surg. 2010;19(2):267–72.CrossRefPubMed Cho NS, Lee BG, Rhee YG. Radiologic course of the calcific deposits in calcific tendinitis of the shoulder: does the initial radiologic aspect affect the final results? J Shoulder Elbow Surg. 2010;19(2):267–72.CrossRefPubMed
27.
Zurück zum Zitat Kwee RM, Kwee TC. Calcified or ossified benign soft tissue lesions that may simulate malignancy. Skelet Radiol. 2019;48(12):1875–90.CrossRef Kwee RM, Kwee TC. Calcified or ossified benign soft tissue lesions that may simulate malignancy. Skelet Radiol. 2019;48(12):1875–90.CrossRef
28.
Zurück zum Zitat Freire V, Moser TP, Lepage-Saucier M. Radiological identification and analysis of soft tissue musculoskeletal calcifications. Insights Imaging. 2018;9(4):477–92.CrossRefPubMedPubMedCentral Freire V, Moser TP, Lepage-Saucier M. Radiological identification and analysis of soft tissue musculoskeletal calcifications. Insights Imaging. 2018;9(4):477–92.CrossRefPubMedPubMedCentral
29.
Zurück zum Zitat Holobinko JN, Damron TA, Scerpella PR, Hojnowski L. Calcific myonecrosis: keys to early recognition. Skelet Radiol. 2003;32(1):35–40.CrossRef Holobinko JN, Damron TA, Scerpella PR, Hojnowski L. Calcific myonecrosis: keys to early recognition. Skelet Radiol. 2003;32(1):35–40.CrossRef
30.
Zurück zum Zitat Rowland F, Call C, Mujtaba B, Amini B, Wang WL. Calcified leiomyoma of the deltoid: pathophysiology and imaging review. Skelet Radiol. 2019;48(4):625–8.CrossRef Rowland F, Call C, Mujtaba B, Amini B, Wang WL. Calcified leiomyoma of the deltoid: pathophysiology and imaging review. Skelet Radiol. 2019;48(4):625–8.CrossRef
31.
Zurück zum Zitat Noel E, Carillon Y, Gaillard T, Bouvier M. Needle aspiration irrigation in calcifying tendinitis of rotator cuff. In: Gazielly DF, Gleyze PT, editors. The Cuff. Paris: Elsevier; 1997. p. 152–7. Noel E, Carillon Y, Gaillard T, Bouvier M. Needle aspiration irrigation in calcifying tendinitis of rotator cuff. In: Gazielly DF, Gleyze PT, editors. The Cuff. Paris: Elsevier; 1997. p. 152–7.
32.
Zurück zum Zitat Tillander B, Franzén LE, Karlsson MH, Norlin R. Effect of steroid injections on the rotator cuff: an experimental study in rats. J Shoulder Elbow Surg. 1999;8(3):271–4.CrossRefPubMed Tillander B, Franzén LE, Karlsson MH, Norlin R. Effect of steroid injections on the rotator cuff: an experimental study in rats. J Shoulder Elbow Surg. 1999;8(3):271–4.CrossRefPubMed
Metadaten
Titel
Chronic intramuscular calcific tendinitis of the deltoid muscle
verfasst von
Yuki Yoshida
Atsushi Yoshida
Publikationsdatum
12.10.2022
Verlag
Springer Berlin Heidelberg
Erschienen in
Skeletal Radiology / Ausgabe 6/2023
Print ISSN: 0364-2348
Elektronische ISSN: 1432-2161
DOI
https://doi.org/10.1007/s00256-022-04203-5

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