X-ray
An AP in external rotation, true AP in internal rotation, axillary and outlet views are sufficient to demonstrate and characterize calcification in any tendon.

Symptoms usually occur if the deposit is larger than 1.5 cm although Friedman found no correlation between the size of the deposit and the severity of the symptoms.

The calcific deposits vary in appearance. Diffuse, heterogeneous, morphous fluffy deposits with poorly definite periphery are associated with acute symptoms and the resorptive phase. Localized homogenous deposits with well-defined limits have been identified with the formative or resting phases or the later chronic phase.

MRI
The calcific deposit causes decreased signal intensity on T-1 weighted images. If edema is present around the deposit, as in the resorptive phase, increased signal intensity around the calcium may show on T-2 weighted images. This increased area of signal intensity should not be misinterpreted as a rotator cuff tear.

MRI is not necessary to detect calcific tendinitis, although its accuracy for finding calcification is more then 95% and it can be helpful in detecting concomitant pathology in chronic stages.

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7/8/2006

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