Original article
Calcific tendinitis: Natural history and association with endocrine disorders

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A retrospective, observational cohort study of 102 consecutive patients (125 shoulders) with calcific tendinitis is presented. Of the patients, 73 (71.6%) were women and 29 (28.4%) were men. Compared with population prevalences, significant levels of endocrine disorders were found. We compared 66 patients (62 women [93.9%] and 4 men [6.1%]; mean age, 50.3 years) (81 shoulders) with associated endocrine disease with 36 patients (11 women [30.6%] and 25 men [69.4%]); mean age, 52.4 years) (44 shoulders) without endocrine disease. The endocrine cohort was significantly younger than the non-endocrine cohort when symptoms started (mean, 40.9 years and 46.9 years, respectively), had significantly longer natural histories (mean, 79.7 months compared with 47.1 months), and had a significantly higher proportion who underwent operative treatment (46.9% compared with 22.7%). Disorders of thyroid and estrogen metabolism may contribute to calcific tendinitis etiology. Classifying calcific tendinitis into type I (idiopathic) and type II (secondary or endocrine-related) aids prognosis and management.

Section snippets

Methods

Computerized hospital records were used to identify all patients diagnosed with calcific tendinitis between August 1996 and July 2001 at our institution. Plain radiographs of all cases were reviewed by the senior author. Cases in which radiographic evidence was inconclusive or that had clearly described dystrophic calcification associated with rotator cuff tears were excluded. With full ethical approval (Oxford Regional Ethics Committee Reference No. C01.171), all patients were interviewed in

Study cohort

Computerized hospital records identified 149 patients diagnosed with calcific tendinitis. Of these, 17 (11.4%) were excluded after radiographic review, 5 (3.3%) were lost to follow-up, and 25 (16.8%) declined to participate. The study cohort of 102 patients (125 shoulders) comprised 73 women (71.6%) and 29 men (28.4%) (P = .0024). Overall, the mean age at onset of symptoms was 43.5 years, with a significant difference in mean age at symptom onset between genders (41.6 years in women vs 48.3

Discussion

The reported prevalence of calcific tendinitis in the general population is highly variable, with estimates varying from 2.7% to 22%.2, 14 Such variations directly reflect the difference in study cohorts and radiographic techniques used. At our institution, 149 patients were diagnosed with calcific tendinitis over a 5-year period (with 102 participating in this study). These are patients who are symptomatic and in whom treatment in primary care has failed and, therefore, must represent a small

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