Calcific tendinitis is a condition characterized by the accumulation of calcium deposits in the tendons of the body. It most commonly affects the rotator cuff tendons in the shoulder. These calcium deposits can cause intense pain and inflammation, limiting the range of motion and impairing daily activities.
Histological Features
On a histological level, calcific tendinitis is marked by the presence of
calcium hydroxyapatite crystals within the tendon tissues. These deposits are typically surrounded by an area of fibrocartilaginous metaplasia, where normal tendon tissue transforms into a cartilage-like tissue. Over time, these calcifications may undergo a process of resorption and repair, where
macrophages and other inflammatory cells are present to remove the deposits and initiate healing.
Pathophysiology
The exact mechanism behind the formation of calcium deposits in tendons is not entirely understood. However, it is believed that the process begins with the degeneration of collagen fibers in the tendon, leading to a fibrocartilaginous transformation. This altered tissue becomes a nidus for calcium crystal deposition. Factors such as
tendon ischemia, repetitive microtrauma, and genetic predisposition may contribute to the development of calcific tendinitis.
Diagnosis
Diagnosis of calcific tendinitis typically involves a combination of clinical assessment and imaging studies. Radiographs can reveal the presence and extent of calcium deposits. In some cases,
ultrasound and magnetic resonance imaging (MRI) may be used to provide a more detailed view of the affected tissues and to assess the surrounding inflammation.
Treatment
Treatment options for calcific tendinitis vary depending on the severity of symptoms and the stage of the condition. Conservative treatments include rest,
nonsteroidal anti-inflammatory drugs (NSAIDs), physical therapy, and corticosteroid injections. In cases where conservative methods fail, more invasive procedures such as
needle aspiration of the calcium deposits, extracorporeal shock wave therapy (ESWT), or surgical removal of the deposits may be necessary.
Prognosis and Recovery
The prognosis for calcific tendinitis is generally favorable, particularly with early intervention and appropriate treatment. Many patients experience significant pain relief and improved function after conservative management or minimally invasive procedures. However, recurrence of calcium deposits can occur, necessitating ongoing monitoring and potential repeat treatments.
Histological Examination Post-Treatment
Histological examination of tendon tissue following treatment can reveal important insights into the healing process. Successful resolution of calcific tendinitis is often marked by the absence of calcium deposits, reduced inflammation, and restoration of normal tendon architecture. In cases where surgical intervention is performed, histological analysis can confirm the complete removal of calcium deposits and assess the extent of any residual damage or fibrosis.
