Calcific tendonitis

Hydroxyapatite deposition disease (HADD) is a condition characterised by calcium deposits in the shoulder that causes pain and inflammation.

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What is calcific tendonitis?

Calcific tendonitis occurs in the tendons of the rotator cuff. The condition occurs when calcium deposits form on the tendons of your shoulder. The tissue around the deposits can become inflamed, causing significant shoulder pain. This condition is fairly common and mostly affects people over the age of 40.

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What are the symptoms of calcific tendonitis?

Symptoms change depending on the stage at which you are at in the development of the condition. These might include:

mild to moderate pain while the calcium is being deposited
significant pain when the deposits are reabsorbed into the tendons of your shoulder
stiffness in the shoulder and difficulty raising your arm
interrupted sleep as a consequence of the pain

How is calcific tendonitis diagnosed?

Your consultant will take your medical history and conduct a physical examination of your shoulder. Imaging tests may be required to confirm calcific tendonitis . These might include:

X-rays to identify the exact location of any calcium deposits in your shoulder
an ultrasound scan to identify the presence of calcium deposits
Your consultant may need to take multiple X-rays over a period of time to check the development of the condition and determine whether surgery is necessary.

Potential treatment options

Anti-inflammatory medication for mild to moderate pain. If the pain is acute your consultant may recommend a steroid injection (cortisone). Resting the arm and shoulder is also advised.
Shockwave therapy. This involves using high energy sound or pressure waves, which can alter the pain while the deposits are reabsorbed. -
Barbotage. This involves removing a deposit by sucking it into a syringe with ultrasound guidance. You may also need surgery, usually arthroscopy. A small incision is made in the shoulder, before a tiny camera and surgical instrument is inserted to remove the deposits. This is more likely with large deposits that have damaged the rotator cuff tendons.