M75.3 Calcific tendinitis of shoulder

Name of the Condition

• Calcific tendinitis of shoulder

Summary

Calcific tendinitis of the shoulder is a condition marked by the deposition of calcium salts within the tendons of the shoulder, most commonly the rotator cuff. This can cause pain, inflammation, and restricted movement. The condition may progress through phases, including a painful acute stage and a resorptive phase where symptoms may improve.

Causes

The exact cause of calcific tendinitis is not fully understood. It is thought to involve degenerative changes in tendon tissue, reduced blood supply, and metabolic imbalances that promote calcium deposition. The process may be related to cellular changes in tendon fibers, leading to calcification.

Risk Factors

• Age: Most common in individuals aged 30-60 years.
• Gender: More prevalent in women.
• Repetitive overhead activities or shoulder strain.
• Underlying metabolic conditions such as diabetes.

Symptoms

• Severe shoulder pain, often worsening at night.
• Limited range of motion in the shoulder.
• Tenderness and swelling around the affected area.
• A catching or clicking sensation during movement.

Diagnosis

Diagnosis is based on clinical evaluation of pain and mobility, supported by imaging. X-rays typically confirm calcium deposits, while ultrasound or MRI may assess tendon involvement and rule out other conditions. Physical examination helps determine the extent of functional impairment.

Treatment Options

• Non-steroidal anti-inflammatory drugs (NSAIDs) to reduce pain and inflammation.
• Physical therapy to improve range of motion and strengthen surrounding muscles.
• Corticosteroid injections for severe pain or inflammation.
• Extracorporeal shock wave therapy (ESWT) to promote calcium resorption.
• Surgical intervention (e.g., arthroscopic removal) for persistent symptoms.

Prognosis and Follow-Up

Most cases improve with conservative treatment over weeks to months. The resorptive phase often leads to symptom resolution, but some individuals may experience prolonged discomfort. Follow-up may include periodic assessments of pain and mobility, with adjustments to therapy as needed.

Complications

• Chronic pain or persistent stiffness.
• Reduced shoulder function affecting daily activities.
• Recurrence of calcium deposits in rare cases.

Lifestyle & Prevention

• Avoid repetitive overhead motions or modify activities to reduce strain.
• Maintain shoulder strength and flexibility through regular exercise.
• Use proper ergonomics during work or sports to minimize stress on the shoulder.

When to Seek Professional Help

Seek care if shoulder pain is severe, worsening, or accompanied by significant loss of motion. Prompt evaluation is recommended if symptoms interfere with daily tasks or fail to improve with self-care measures.

Tips for Medical Coders

Document the presence of calcium deposits in shoulder tendons, typically confirmed by imaging. Note the affected shoulder (e.g., right, left, bilateral) and any associated symptoms or treatments. Ensure clinical correlation with imaging findings to support the diagnosis.