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Delbello F, Spinnato P, Aparisi Gomez MP. Calcific Tendinopathy Atypically Located Outside the Rotator Cuff: A Systematic Review. Curr Med Imaging 2024; 20:e100423215585. [PMID: 37038296 DOI: 10.2174/1573405620666230410091749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 01/24/2023] [Accepted: 02/20/2023] [Indexed: 04/12/2023]
Abstract
BACKGROUND AND PURPOSE Calcific tendinopathy is a common cause of painful shoulder easily identified with ultrasound or conventional radiography. Although the rotator cuff is by far the most common location of the disease and diagnostic or treatment strategies are well known in clinical practice, a lack of awareness characterizes the assessment of the other sites affected by this condition; consequently, the risk of underestimating the prevalence of atypical non-rotator cuff calcific tendinopathy is high. This may lead to expensive or invasive diagnostic exams and/or inappropriate treatment, whereas the condition is usually self-limited. The present study aims at analysing the frequency of calcific tendinitis in uncommon sites, in order to fill a gap in knowledge and awareness regarding non-rotator cuff calcific tendinopathy, thus avoiding improper clinical choices and helping to identify this condition. METHODS This systematic review was conducted following the PRISMA guidelines. We performed a search on Pubmed and Scopus databases concerning atypically sited extra-rotator cuff calcific tendinopathy published since 1950. RESULTS The research found a total of 267 articles and 793 non-rotator cuff cases of calcific tendinopathy registered. The spine (213 – 26.86%), foot and ankle (191 – 23.95%), and hip (175 – 22.06%) appeared to be the most common sites of calcific tendinopathy after the rotator cuff, whereas the longus colli C1-C2 (204 – 25.72%), Achilles (173 – 21.81%), and rectus femori (61 – 7.69%) were the most commonly affected tendons. CONCLUSION A better awareness of this condition in several different sites of the body than the rotator cuff could avoid unnecessary choices both in assessment and treatment.
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Affiliation(s)
- Federica Delbello
- Department of Rehabilitation Medicine, Gervasutta Hospital, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
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Draghi F, Cocco G, Lomoro P, Bortolotto C, Schiavone C. Non-rotator cuff calcific tendinopathy: ultrasonographic diagnosis and treatment. J Ultrasound 2020; 23:301-315. [PMID: 31197633 PMCID: PMC7441123 DOI: 10.1007/s40477-019-00393-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Accepted: 05/31/2019] [Indexed: 12/13/2022] Open
Abstract
Calcific tendinopathy is a condition that is related to the deposition of calcium, mostly hydroxyapatite crystals, within the tendons. The shoulder and the hip are commonly affected joints, but calcific tendinopathy may occur in any tendon of the body. While there is an extensive literature on the ultrasound diagnosis of calcific tendinopathy of the shoulder, there are only sporadic reports on other sites. This review combines the experience of our centers and a thorough analysis of the literature from the last 45 years (1972-2017) in order to highlight the localizations beyond the rotator cuff, their ultrasound characteristics and therapeutic possibilities.
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Affiliation(s)
- Ferdinando Draghi
- Radiology Institute, IRCCS Policlinico San Matteo Foundation, University of Pavia, Viale Camillo Golgi 19, 27100, Pavia, Italy
| | - Giulio Cocco
- Department of Medicine and Aging Sciences, University of Chieti G d'Annunzio, Via dei Vestini 31, 66100, Chieti, Italy
| | - Pascal Lomoro
- Radiology Institute, IRCCS Policlinico San Matteo Foundation, University of Pavia, Viale Camillo Golgi 19, 27100, Pavia, Italy
| | - Chandra Bortolotto
- Radiology Institute, IRCCS Policlinico San Matteo Foundation, University of Pavia, Viale Camillo Golgi 19, 27100, Pavia, Italy.
| | - Cosima Schiavone
- Department of Medicine and Aging Sciences, University of Chieti G d'Annunzio, Via dei Vestini 31, 66100, Chieti, Italy
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Zapolsky N, Heller M, Felberbaum M, Rose J, Steinberg E. Calcific Tendonitis of the Longus Colli: An Uncommon but Benign Cause of Throat Pain that Closely Mimics Retropharyngeal Abscess. J Emerg Med 2016; 52:358-360. [PMID: 27765436 DOI: 10.1016/j.jemermed.2016.08.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2016] [Revised: 08/09/2016] [Accepted: 08/18/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Nathan Zapolsky
- Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai Beth Israel, New York, New York
| | - Michael Heller
- Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai Beth Israel, New York, New York
| | - Mark Felberbaum
- Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai Beth Israel, New York, New York
| | - Jeremy Rose
- Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai Beth Israel, New York, New York
| | - Eric Steinberg
- Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai Beth Israel, New York, New York
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Yaylacı S, Öztürk TC, Aksoy E, Koçyigit A, Yılmaz A, Karaarslan E. Retropharyngeal calcific tendinitis: Report of two cases. J Emerg Trauma Shock 2015; 8:119-20. [PMID: 25949045 PMCID: PMC4411574 DOI: 10.4103/0974-2700.145408] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Affiliation(s)
- Serpil Yaylacı
- Department of Emergency Medicine, Acibadem University, School of Medicine, Istanbul, Turkey
| | - Tuba Cimilli Öztürk
- Fatih Sultan Mehmet Education And Research Hospital, Emergency Medicine Clinic, Istanbul, Turkey
| | - Elif Aksoy
- Department of Otorhinolaryngology, Acibadem University, School of Medicine, Istanbul, Turkey
| | - Ali Koçyigit
- Department of Radiology, Pamukkale University, School of Medicine, Denizli, Turkey
| | - Atakan Yılmaz
- Department of Emergency Medicine, Tekirdağ State Hospital, Tekirdağ, Turkey
| | - Ercan Karaarslan
- Department of Radiology, Acibadem University, School of Medicine, Istanbul, Turkey E-mail:
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Acute severe neck pain and dysphagia following cervical maneuver: diagnostic approach. Eur Ann Otorhinolaryngol Head Neck Dis 2013; 131:135-8. [PMID: 23845292 DOI: 10.1016/j.anorl.2013.03.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2012] [Revised: 03/13/2013] [Accepted: 03/19/2013] [Indexed: 10/26/2022]
Abstract
INTRODUCTION Overlooking an etiologic hypothesis in acute neck pain with dysphagia may lead to misdiagnosis. CASE REPORT A 51-year-old man who had received cervical manipulation came to the emergency unit with evolutive acute neck pain, cervical spine stiffness and odynophagia, without fever or other signs of identified pathology. Cervical X-ray and CT angiography of the supra-aortic vessels ruled out traumatic etiology (fracture or arterial dissection) and revealed an accessory bone, orienting diagnosis toward retropharyngeal abscess, which was, however, belied by endoscopy performed under general anesthesia. A second CT scan with contrast injection and tissue phase ruled out infection, revealing a retropharyngeal calcification inducing retropharyngeal edema. Evolution under analgesics was favorable within 13 days. DISCUSSION Given a clinical triad associating acute neck pain, cervical spine stiffness and odynophagia, traumatic or infectious etiology was initially suspected. Cervical CT diagnosed calcific tendinitis of the longus colli, revealing a pathognomic retropharyngeal calcification. Secondary to hydroxyapatite deposits anterior to the odontoid process of the axis, this is a rare form of tendinopathy, usually showing favorable evolution in 10-15 days under analgesic and anti-inflammatory treatment.
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Terao K, Kusunoki T, Mori K, Murata K, Doi K. A Case of Calcific Retropharyngeal Tendinitis: The Significance of an Early Diagnosis. EAR, NOSE & THROAT JOURNAL 2013. [DOI: 10.1177/014556131309200210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The clinical presentation of calcific retropharyngeal tendinitis, a rare entity, can mimic more serious disorders. We describe the case of a 35-year-old man who was referred to us for evaluation of a suspected retropharyngeal abscess. At presentation, the patient reported severe cervical pain and stiffness. He exhibited mild fever, torticollis, and a moderately elevated white blood count; no swelling of the retropharyngeal wall was observed. Based on the results of plain radiography and computed tomography (CT), we diagnosed the patient with calcific retropharyngeal tendinitis. He was treated with a 7-day course of a nonsteroidal anti-inflammatory drug and a 3-day course of a steroid, and he recovered well. We suggest that the true incidence of calcific retropharyngeal tendinitis is actually higher than what is generally believed because this diagnosis is frequently missed. Contrast-enhanced CT can aid in diagnosing calcific retropharyngeal tendinitis. CT should be performed in patients who present with nonspecific symptoms such as severe neck pain, sore throat, odynophagia, and mild fever.
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Affiliation(s)
- Kyoichi Terao
- Department of Otolaryngology, Kinki University Faculty of Medicine, Osaka, Japan
| | | | - Kazunori Mori
- Department of Otolaryngology, Kinki University Faculty of Medicine, Osaka, Japan
| | - Kiyotaka Murata
- Department of Otolaryngology, Kinki University Faculty of Medicine, Osaka, Japan
| | - Katsumi Doi
- Department of Otolaryngology, Kinki University Faculty of Medicine, Osaka, Japan
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Benign febrile cervicalgia due to calcific retropharyngeal tendinitis: case study. Orthop Traumatol Surg Res 2011; 97:341-4. [PMID: 21458398 DOI: 10.1016/j.otsr.2010.09.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2010] [Revised: 07/14/2010] [Accepted: 09/06/2010] [Indexed: 02/02/2023]
Abstract
Periarticular calcific tendinopathy has been well described, but no retropharyngeal locations have been reported in the surgical orthopedic literature. This pathology is a diagnostic pitfall, leading to fruitless invasive examinations and treatment. The clinical aspect is misleading, but pathognomic imaging can establish diagnosis. We report a case of febrile postoperative cervicalgia, initially suggestive of a septic complication, but in which imaging indicated retropharyngeal calcific tendinitis.
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Park R, Halpert DE, Baer A, Kunar D, Holt PA. Retropharyngeal Calcific Tendinitis: Case Report and Review of the Literature. Semin Arthritis Rheum 2010; 39:504-9. [DOI: 10.1016/j.semarthrit.2009.04.002] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2008] [Revised: 04/27/2009] [Accepted: 04/29/2009] [Indexed: 11/24/2022]
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Acute posterior neck pain in adult: a case series. CASES JOURNAL 2009; 2:8103. [PMID: 19918452 PMCID: PMC2769402 DOI: 10.4076/1757-1626-2-8103] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/01/2009] [Accepted: 06/25/2009] [Indexed: 11/24/2022]
Abstract
Calcification around the cervical spine is thought to be relatively rare case, among these conditions the calcification at the longus colli muscle is called retropharyngeal tendinitis and only several cases were reported in the literature. In this disease, the three characteristic clinical features are acute severe posterior neck pain without any trigger, severely restricted range of motion, and odynophagia. The radiographic findings include swelling of the retropharyngeal space and amorphous calcification anterior to C1-C2 in lateral view of the cervical spine. Diagnosis is established by sound history taking coupled with computed tomography (CT) scan of the affected area, treatment is the administration of oral non-steroidal anti-inflammatory drugs (NSAID), for a few weeks and/or oral steroid. We present a new 3 cases (27, 35, and 24 years old, male) and review of literature.
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