M75.32 Calcific tendinitis of left shoulder

Name of the Condition

• Calcific tendinitis of left shoulder

Summary

Calcific tendinitis of the left shoulder is a condition characterized by the deposition of calcium salts within the tendons of the left shoulder, most commonly the rotator cuff. This can lead to 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 exam findings, such as pain with specific shoulder movements, also aid in diagnosis.

Treatment Options

• Non-steroidal anti-inflammatory drugs (NSAIDs) to reduce pain and inflammation.
• Physical therapy to improve range of motion and strengthen shoulder muscles.
• Corticosteroid injections for severe pain or inflammation.
• Extracorporeal shock wave therapy (ESWT) to break up calcium deposits.
• In rare cases, surgical intervention may be considered for persistent symptoms.

Prognosis and Follow-Up

Most cases of calcific tendinitis improve with conservative treatment over time. The resorptive phase often leads to symptom resolution, but recovery can take several months. Follow-up care may include periodic imaging to monitor calcium deposit changes and physical therapy to maintain mobility.

Complications

• Chronic pain or persistent stiffness if untreated.
• Tendon rupture in severe cases.
• Reduced shoulder function affecting daily activities.

Lifestyle & Prevention

• Avoid repetitive overhead motions or modify activities to reduce strain.
• Maintain shoulder strength and flexibility through regular exercise.
• Use proper form during sports or manual labor to minimize injury risk.
• Apply ice to the shoulder after strenuous activity to reduce inflammation.

When to Seek Professional Help

Seek medical attention if shoulder pain is severe, worsening, or accompanied by significant loss of motion. Immediate care is recommended if symptoms interfere with daily tasks or if there is a sudden increase in pain or swelling.

Tips for Medical Coders

Document the specific shoulder affected (left) and confirm the presence of calcific deposits via imaging or clinical findings. Ensure the diagnosis aligns with the clinical presentation and imaging results to support accurate coding. Note any contributing factors, such as repetitive strain or metabolic conditions, to provide context for the diagnosis.