Relationship between calcific tendinopathy and rotator cuff tear on shoulder magnetic resonance imaging: case-controlled comparison
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School of Health Sciences, Istanbul Gelisim University, Istanbul, Turkey
Department of Radiology, Private Nisa Hospital, Istanbul, Turkey
Submission date: 2019-10-21
Final revision date: 2019-12-02
Acceptance date: 2019-12-02
Publication date: 2020-01-08
Pol J Radiol, 2020; 85: 8-13
To determine the frequency of rotator cuff tear on the shoulder magnetic resonance imaging (MRI) of patients with rotator cuff calcific tendinopathy and the relationship between rotator cuff tear and calcific tendinopathy.

Material and methods:
In this retrospective case control study, 137 patients with calcific tendinopathy and 137 control group patients without calcific tendinopathy with shoulder pain, whose age, sex, and shoulder laterality values were matched, were compared in terms of rotator cuff tears on their shoulder MRI images.

The frequency of rotator cuff tear was found to be significantly higher in the control group (37.2%) compared to the calcific tendinopathy group (23.4%) (p < 0.01). Partial thickness was 81.3% in the calcific tendinopathy group and 70.6% in the control group, and no significant difference was observed between the two groups in terms of the size of the rotator cuff tear (p > 0.05). In the calcific tendinopathy group, there was no significant relationship between the localisation of calcification and the rotator cuff tear, and only in 4.4% of the participants were calcification and tear at the same location on the same tendon (p > 0.05, r = 0.04).

The patients with calcific tendinopathy, who had been admitted with shoulder pain, did not demonstrate an increased risk of rotator cuff tear based on their MRI compared to patients with shoulder pain without calcific tendinopathy. No significant relationship was determined between calcific tendinopathy and rotator cuff tear.

Komurcu M, Kilic E. Calcifying tendinitis: etiology, pathogenesis and treatment methods. Turkiye Klinikleri J Surg Med Sci 2007; 3: 17-21.
Greis AC, Derrington SM, McAuliffe M. Evaluation and nonsurgical management of rotator cuff calcific tendinopathy. Orthop Clin North Am 2015; 46: 293-302.
Reilly P, Macleod I, Macfarlane R, et al. Dead men and radiologists don’t lie: a review of cadaveric and radiological studies of rotator cuff tear prevalence. Ann R Coll Surg Engl 2006; 88: 116-21.
Beckmann NM, Tran MQ, Cai C. Incidence of rotator cuff tears in the setting of calcific tendinopathy on MRI: a case controlled comparison. Skeletal Radiol 2019; 48: 245-250.
Rathbun JB, Macnab I. The microvascular pattern of the rotator cuff. J Bone Joint Surg Br 1970; 52: 540-553.
Moseley HF, Goldie I. The arterial pattern of the rotator cuff of the shoulder. J Bone Joint Surg 1963; 48: 780.
Jim YF, Hsu HC, Chang CY, Wu JJ, Chang T. Coexistence of calcific tendinitis and rotator cuff tear: an arthrographic study. Skeletal Radiol 1993; 22: 183-185.
Wolfgang GL. Surgical repair of tears of the rotator cuff of the shoulder: factors influencing the result. J Bone Joint Surg Am 1974; 56: 14-26.
McLaughlin HL, Asherman EG. Lesions of the musculotendinous cuff of the shoulder. IV. Some observations based upon the results of surgical repair. J Bone Joint Surg Am 1951; 33: 76-86.
Merolla G, Singh S, Paladini P, Porcellini G. Calcific tendinitis of the rotator cuff: state of the art in diagnosis and treatment. J Orthopaed Traumatol 2016; 17: 7-14.
Codman EA. The Shoulder: Rupture of the Supraspinatus Tendon and Other Lesions in or about the Subacromial Bursa. Thomas Todd Co., Boston 1934.
Mohr W, Bilger S. Basic morphologic structures of calcified tendinopathy and their significance for pathogenesis. Z Rheumatol 1990; 49: 346-355.
Uhthoff HK, Sarkar K, Maynard JA. Calcifying tendinitis: a new concept of its pathogenesis. Clin Orthop Relat Res 1976; 118: 164-168.
Rui YF, Lui PP, Chan LS, et al. Does erroneous differentiation of tendon-derived stem cells contribute to the pathogenesis of calcifying tendinopathy? Chin Med J 2011; 124: 606-610.
Harvie P, Pollard TC, Carr AJ. Calcific tendinitis: natural history and association with endocrine disorders. J Shoulder Elbow Surg 2007; 16: 169-173.
Mavrikakis ME, Drimis S, Kontoyannis DA, et al. Calcific shoulder periarthritis (tendinitis) in adult onset diabetes mellitus: a controlled study. Ann Rheum Dis 1989; 48: 211-214.
Zhang Y, Johnson K, Russell RG, et al. Association of sporadic chondrocalcinosis with a –4-basepair G-to-A transition in the 50-untranslated region of ANKH that promotes enhanced expression of ANKH protein and excess generation of extracellular inorganic pyrophosphate. Arthritis Rheum 2005; 52: 1110-1117.
Sengar DP, McKendry RJ, Uhthoff HK. Increased frequency of HLA-A1 in calcifying tendinitis. Tissue Antigens 1987; 29: 173-174.
Oliva F, Barisani D, Grasso A, Maffulli N. Gene expression analysis in calcific tendinopathy of the rotator cuff. Eur Cell Mater 2011; 21: 548-557.
Via AG, De Cupis M, Spoliti M, Oliva F. Clinical and biological aspects of rotator cuff tears. Muscles Ligaments Tendons J 2013; 3: 70-79.
ElShewy MT. Calcific tendinitis of the rotator cuff. World J Orthop 2016; 7: 55-60.
Jozsa L, Balint BJ, Reffy A. Calcifying tendinopathy. Arch Orthop Trauma Surg 1980; 97: 305-307.
Kernwein GA. Roentgenographic diagnosis of shoulder dysfunction. JAMA 1965; 194: 179-183.
Sakamoto K, Kozuki K. Calcific tendinitis at the biceps brachii insertion of a child: a case report. J Shoulder Elbow Surg 2002; 11: 88-91.
Sher JS, Uribe JW, Posada A, et al. Abnormal findings on magnetic resonance images of asymptomatic shoulders. J Bone Joint Surg Am 1995; 77: 10-15.
Gartsman GM. Calcific tendinitis. In: Shoulder Arthroscopy. 2nd ed. Saunders Elsevier, Philadelphia 2009; 316-321.
Porcellini G, Paladini P, Campi F, Pegreffi F. Osteolytic lesion of greater tuberosity in calcific tendinitis of the shoulder. J Shoulder Elbow Surg 2009; 18: 210-215.
Maier M, Stäbler A, Schmitz C, et al. On the impact of calcified deposits within the rotator cuff tendons in shoulders of patients with shoulder pain and dysfunction. Arch Orthop Trauma Surg 2001; 121: 371-378.
Chan R, Kim D, Millet P, Weissman BN. Calcifying tendinitis of rotator cuff with cortical bone erosion. Skeletal Radiol 2004; 33: 596-599.
Norenberg D, Ebersbergere HU, Walter T, et al. Diagnosis of calcific tendonitis of the rotator cuff by using susceptibility-weighted MR imaging. Radiology 2016; 278: 475-484.
Chiou HJ, Chou YH, Wu JJ, Hsu CC. Evaluation of calcific tendonitis of the rotator cuff: role of color doppler ultrasonography. J Ultrasound Med 2002; 21: 289-295.
Clavert P, Sirveaux F. Shoulder calcifying tendinitis. Rev Chir Orthop Reparatrice Appar Mot 2008; 94 (8 suppl): 336-355.
Rhee YG, Kim YH, Park MS. Arthroscopic treatment in calcific tendinitis of the shoulder. J Korean Shoulder Elbow Soc 2000; 3: 68-74.
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