DOI QR코드

DOI QR Code

Calcific Tendinitis of Shoulder Associated with Intraosseous Involvement -A Case Report-

골내 침범을 동반한 견관절 석회화 건염 - 증례 보고 -

  • Ku, Jung-Hoei (Department of Orthopaedic Surgery, Good Samsun Hospital) ;
  • Cho, Hyung-Lae (Department of Orthopaedic Surgery, Good Samsun Hospital) ;
  • Park, Man-Jun (Department of Orthopaedic Surgery, Good Samsun Hospital) ;
  • Kim, Jeong-Cheol (Department of Orthopaedic Surgery, Good Samsun Hospital)
  • 구정회 (좋은삼선병원 정형외과) ;
  • 조형래 (좋은삼선병원 정형외과) ;
  • 박만준 (좋은삼선병원 정형외과) ;
  • 김정철 (좋은삼선병원 정형외과)
  • Received : 2011.10.04
  • Accepted : 2011.11.18
  • Published : 2011.12.31

Abstract

Purpose: We present an atypical case of calcific tendinitis of the shoulder with intraosseous loculation. Materials and Methods: A 59 year-old female complained of acute exacerbation of chronic left shoulder pain and restricted range of motion. Simple radiographs showed a subacromial calcific deposit and magnetic resonance imaging revealed cortical erosion with intraosseous extension of calcific material mimicking infection or tumor. She was managed with arthroscopic excision of the calcific deposit, curettage of the intraosseous lesion and subsequent rotator cuff repair with a suture anchor. Results: Her acute pain promptly subsided. Her rehabilitation was uneventful and she gained full range of motion. Radiographs five months after the operation showed no recurrence of calcific material. Conclusion: Calcific tendinitis of the shoulder can present with a variety of images involving the adjacent bone. The correct recognition of this disorder may avoid unnecessary investigation and treatment.

목적: 골내 침범이 동반된 비전형적인 견관절 석회화 건염 1예를 보고하고자 한다. 대상 및 방법: 만성적인 좌측 견관절 동통의 급성 악화와 운동 제한을 주소로 내원한 59세 여자 환자로 단순 방사선 상 견봉하 석회 침착과 자기 공명 영상 상 감염이나 종양과 유사하게 골 피질을 침범하고 석회 물질이 골 내부로 연장되어 있었다. 관절경하 석회 제거술과 골내 석회의 소파술, 건 결손부에 봉합 나사못을 이용한 회전근 개 봉합술을 시행하였다. 결과: 환자의 급성 견관절 통증은 술 후 즉각적인 호전을 보였고 순조로운 재활 경과와 관절 운동범위의 회복을 보였다. 술 후 5개월에 촬영한 단순 방사선 상 석회 침착의 재발은 관찰되지 않았다. 결론: 견관절 석회화 건염은 주위 골조직으로 연장된 다양한 영상 소견을 나타 낼 수 있으며, 질환을 정확히 판별함으로써 불필요한 검사나 치료를 피할 수 있을 것으로 생각된다.

Keywords

References

  1. Speed CA, Hazleman B. Calcifying tendinitis of the shoulder. N Engl J Med. 1999;340:1582-4. https://doi.org/10.1056/NEJM199905203402011
  2. Flemming DJ, Murphry MD, Shekitka KM, Temple HT, Jelinek JJ, Kransdorf MJ. Osseous involvement in calcific tendinitis. A retro-spective review of 50 cases. Am J Roentgenol. 2003;181:965-72. https://doi.org/10.2214/ajr.181.4.1810965
  3. Bosworth BM. Calcium deposits in the shoulder and subacromial bursitis. A survey of 12,122 shoulders. JAMA. 1941;2477-82.
  4. Hayes CW, Rosenthal DI, Plata MJ, Hudson TM. Calcific tendinitis in unusual sites associated with cortical bone erosion. Am J Roentgenol. 1987;149:967-70. https://doi.org/10.2214/ajr.149.5.967
  5. Uhthoff HK, Loehr JW. Calcific tendinopathy of the rotator cuff. Pathogenesis, diagnosis and management. J Am Acad Orthop Surg. 1997;5:183-91.
  6. Durr HR, Lienemann A, Silbernagl H, Nerlich A, Refior HJ. Acute calcific tendinitis of the pectoralis major insertion associated with cortical bone erosion. Eur Radiol. 1997;7:1215-7. https://doi.org/10.1007/s003300050277
  7. Seyahi A, Demirhan M. Arthroscopic removal of intraosseous and intratendinous deposits in calcifying tendinitis of the rotator cuff. Arthroscopy. 2009; 25:590-6. https://doi.org/10.1016/j.arthro.2008.12.024
  8. Chan R, Kim DH, Millett PJ, Weissman BN. Calcifying tendinitis of the rotator cuff with cortical bone erosion. Skeletal Radiol. 2004;33:596-6. https://doi.org/10.1007/s00256-004-0770-1
  9. Jerosch J, Strauss JM, Schmiel SJ. Arthroscopic treatment of calcific tendinitis of the shoulder. J Shoulder Elbow Surg. 1998;7:30-7. https://doi.org/10.1016/S1058-2746(98)90180-X
  10. Choi CH, Kim SK, Lee HH. Conservative and arthroscopic treatment of calcific tendinitis. J Korean Shoulder Elbow Soc. 2007;10:167-74. https://doi.org/10.5397/CiSE.2007.10.2.167

Cited by

  1. Acute calcific tendinitis of the rectus femoris associated with intraosseous involvement: a case report with serial CT and MRI findings vol.23, pp.S2, 2013, https://doi.org/10.1007/s00590-012-1156-z