Acute severe shoulder pain, suspected calcific tendinitis
Recommended: X-ray Shoulder (calcium deposits in rotator cuff) is the preferred imaging study for acute severe shoulder pain, suspected calcific tendinitis. Hydroxyapatite deposits in supraspinatus tendon most common.
Recommended study
X-ray Shoulder (calcium deposits in rotator cuff)
Hydroxyapatite deposits in supraspinatus tendon most common. Acute resorptive phase causes severe pain.
If the default doesn't apply
US-guided barbotage / aspiration
US
Ultrasound Shoulder + needling
No contrast
Watch-outs
Acute resorptive phase mimics infection
Severe pain + warm joint + elevated inflammatory markers — distinguish from septic bursitis.
Pearls
- Gartner classification (Type I dense, II intermediate, III fluffy) — fluffy = resorptive, more painful, more responsive.
- Most common in supraspinatus (critical zone).
- Treatment: NSAIDs, US-guided barbotage / lavage, steroid injection, ESWT.