M65.2 Calcific tendinitis

Name of the Condition

• Calcific tendinitis
• Also known as calcific tendinopathy or calcium deposit tendinitis.

Summary

Calcific tendinitis is a condition characterized by the buildup of calcium deposits in the tendons, leading to pain, inflammation, and restricted movement. It commonly affects tendons around joints and may occur without a specific prior injury.

Causes

The exact cause of calcific tendinitis is not well understood. It is thought to involve a combination of factors, including overuse of the tendons, age-related changes, and impaired blood flow leading to calcification in the tendon fibers.

Risk Factors

• Age: Typically occurs between 30-60 years.
• Occupations or activities requiring repetitive movements.
• Previous tendon or joint issues.
• Chronic conditions such as diabetes.

Symptoms

• Intense pain and tenderness in the affected area.
• Reduced range of motion or stiffness.
• Swelling and warmth over the affected tendon.
• A noticeable lump where the deposit has formed.

Diagnosis

Diagnosis typically involves a physical examination to assess pain and mobility. Imaging tests, such as X-rays or ultrasound, are used to visualize calcium deposits. MRI may be employed for detailed tendon evaluation.

Treatment Options

• Non-Surgical:
  • Rest and activity modification.
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) to reduce pain and inflammation.
  • Physical therapy to improve mobility and strength.
  • Corticosteroid injections for severe pain.
• Surgical:
  • Procedures to remove calcium deposits if conservative treatments fail.

Prognosis and Follow-Up

Most cases improve with conservative treatment, though recovery may take weeks to months. Follow-up care may include monitoring for recurrence and ongoing physical therapy. Surgical outcomes are generally favorable but depend on the extent of tendon damage.

Complications

• Chronic pain or persistent stiffness.
• Tendon rupture in rare cases.
• Recurrence of calcium deposits.

Lifestyle & Prevention

• Avoid repetitive or strenuous movements that strain tendons.
• Maintain proper ergonomics during work or sports.
• Engage in regular stretching and strengthening exercises.
• Manage underlying conditions like diabetes to reduce risk.

When to Seek Professional Help

Seek medical attention if pain is severe, worsening, or accompanied by swelling, redness, or fever. Prompt evaluation is recommended if mobility is significantly impaired.

Tips for Medical Coders

Document the affected tendon location and any associated symptoms. Ensure clinical notes support the diagnosis, including imaging findings or physical exam details. Verify that the code aligns with the specific anatomical site documented.