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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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Qureshi PAAA, Bollason G, Ágústsson KL. Acute Calcific Tendinitis of the Longus Colli Muscles: An Entity That Should Be Known by Emergency Radiologists. Cureus 2022; 14:e25518. [PMID: 35800797 PMCID: PMC9245335 DOI: 10.7759/cureus.25518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/31/2022] [Indexed: 11/09/2022] Open
Abstract
Acute calcific tendinitis of the longus colli muscle (LCM) also called acute calcific prevertebral tendinitis or retropharyngeal tendinitis is an inflammatory process of the LCM that results in acute and debilitating symptoms. Although the imaging appearances of this uncommon condition are specific, due to the rarity of this entity and lack of familiarity, it can be sometimes misdiagnosed as a retropharyngeal abscess. This case report presents characteristic radiological features of the acute calcific tendinitis of the LCM, which may be helpful for the emergency radiologist to accurately diagnose this condition to avoid unnecessary surgical interventions.
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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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Shawky A, Elnady B, El-Morshidy E, Gad W, Ezzati A. Longus colli tendinitis. A review of literature and case series. SICOT J 2017; 3:48. [PMID: 28664844 PMCID: PMC5492790 DOI: 10.1051/sicotj/2017032] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2016] [Accepted: 05/09/2017] [Indexed: 12/05/2022] Open
Abstract
Purpose: To increase the awareness of longus colli tendinitis (LCT) among spine specialists and to present a practical overview of diagnostic and treatment options, so that unnecessary interventions are avoided. Five sample cases from a German spine center will also be presented. Methods: Literature review and case series. A PubMed search was performed in May 2015, and the articles found were reviewed for clinical presentation, investigations, and treatment. The frequency of publication of LCT cases and the specialty of journals were also noted. Recent cases treated in our institution were also reviewed. The clinical findings, investigations, and therapeutic interventions were summarized. Results: The PubMed search from May 2015 found 104 articles, published over 51 years, on the topic of LCT. Only four were published in spine journals. A review of this literature yielded a total of 242 cases. The classic clinical triad included neck pain, limitation of movements, and swallowing complaints. C-reactive Protein (CRP) values were available in 21 cases (mean 23.66 mg/dL). A contrast-enhanced computed tomography (CT) scan was the best diagnostic modality. LCT is usually a self-limiting condition, but non-steroidal anti-inflammatory drugs (NSAIDs) may help alleviate discomfort. Five cases of LCT were diagnosed and treated in our center over the past three years. Conclusions: LCT, which is uncommon and has non-specific symptoms, is often referred to spine centers. Spine specialists should be aware of its clinical presentation and radiographic findings in order to avoid unnecessary interventions. The condition is self-limiting and can be treated conservatively.
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Affiliation(s)
- Ahmed Shawky
- Department of Orthopedics and Trauma Surgery, Assiut University Hospitals, 71111 Assiut, Egypt - Spine Center, Helios Klinikum Erfurt, Nordhaeuser street 74, 99089 Erfurt, Germany
| | - Belal Elnady
- Department of Orthopedics and Trauma Surgery, Assiut University Hospitals, 71111 Assiut, Egypt
| | - Essam El-Morshidy
- Department of Orthopedics and Trauma Surgery, Assiut University Hospitals, 71111 Assiut, Egypt
| | - Wael Gad
- Department of Orthopedics and Trauma Surgery, Assiut University Hospitals, 71111 Assiut, Egypt
| | - Ali Ezzati
- Spine Center, Helios Klinikum Erfurt, Nordhaeuser street 74, 99089 Erfurt, Germany
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Silva CF, Soffia PS, Pruzzo E. Acute prevertebral calcific tendinitis: a source of non-surgical acute cervical pain. Acta Radiol 2014; 55:91-4. [PMID: 23864065 DOI: 10.1177/0284185113492151] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Prevertebral calcific tendinitis results from calcium hydroxyapatite crystal deposits in the longus colli muscles, which induce symptoms similar to some surgically-treated conditions, such as retropharyngeal abscesses. Imaging techniques are critical for accurate diagnosis. PURPOSE To describe the computed tomography (CT) findings associated with prevertebral calcific tendinitis. MATERIAL AND METHODS Retrospective analysis performed in an 18-month period, searching for patients with neck CT and reports with diagnosis of "calcific longus collis tendinitis" or "prevertebral calcific tendinitis". CT images and clinical data available in the medical records were analyzed. RESULTS One hundred and thirty-four examinations were performed in the period studied. Nine patients who fulfilled inclusion criteria were identified and their CT imaging characteristics are presented. Six presented with calcific deposits in the right longus colli muscle. CT matched the clinical pain lateralization in all cases. Eight patients had no significant enhancement post injection of contrast media. CONCLUSION Prevertebral calcific tendinitis is a cause of acute cervical pain that clinically mimics a retropharyngeal abscess, however on neck CT has a characteristic appearance. Correct identification of this pathologic condition will help avoiding unnecessary invasive procedures.
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Affiliation(s)
- Claudio F Silva
- Departamento de Imágenes, Clinica Alemana de Santiago, Facultad de Medicina Clínica Aleman, Universidad del Desarrollo, Santiago, Chile
| | - Pablo S Soffia
- Departamento de Imágenes, Clinica Alemana de Santiago, Facultad de Medicina Clínica Aleman, Universidad del Desarrollo, Santiago, Chile
| | - Edda Pruzzo
- Departamento de Otorhinolaryngology, Clinica Alemana de Santiago, Facultad de Medicina Clínica Alemana – Universidad del Desarrollo, Santiago, Chile
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Park J, Lee S, Joo KB. Growing heterotopic calcification in the prevertebral space of a cervical spine as a late complication of irradiation: case report. Korean J Radiol 2014; 15:140-4. [PMID: 24497804 PMCID: PMC3909847 DOI: 10.3348/kjr.2014.15.1.140] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2013] [Accepted: 10/10/2013] [Indexed: 11/15/2022] Open
Abstract
Heterotopic calcification following head and neck irradiation has rarely been reported. It usually develops as a late complication of radiotherapy in patients with malignancies, including breast cancer, lymphoma, and genitourinary malignancies. The occurrence of heterotopic calcification in the prevertebral space of the cervical spine has not been described as a late complication of irradiation. Here, we report a case of prevertebral heterotopic calcification in a patient with history of chemotherapy and radiotherapy for tonsil cancer 21 years ago.
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Affiliation(s)
- Jina Park
- Department of Radiology, Hanyang University Hospital, Seoul 133-792, Korea
| | - Seunghun Lee
- Department of Radiology, Hanyang University Hospital, Seoul 133-792, Korea
| | - Kyung Bin Joo
- Department of Radiology, Hanyang University Hospital, Seoul 133-792, Korea
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Buch K, Nadgir RN, Tannenbaum AD, Ozonoff A, Fujita A, Sakai O. Clinical significance of trochlear calcifications in the orbit. AJNR Am J Neuroradiol 2013; 35:573-7. [PMID: 23945224 DOI: 10.3174/ajnr.a3697] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND AND PURPOSE Trochlear calcification is frequently seen on CT scans that include the orbits, but prior studies linking this finding to diabetes mellitus were based on selected populations by using relatively thick sections. We assessed the relationship between trochlear calcification and diabetes mellitus and other chronic medical conditions in an unrestricted population by using thin-section CT. MATERIALS AND METHODS Noncontrast head CT studies performed consecutively on 1000 patients between January and February 2011 were retrospectively reviewed for the presence of trochlear calcifications. Axial 1.25-mm-thick images acquired by 64-detector row CT were reviewed. Medical records were reviewed for chronic medical conditions, including diabetes mellitus, chronic kidney disease, alcoholism, autoimmune conditions, endocrine disorders, serum calcium and alkaline phosphatase levels, and HIV status. Motion-limited studies and patients with limited clinical data were excluded. Statistical analyses were performed by using the Fisher exact test. RESULTS Thirty-two patients were excluded from analysis. Of the remaining 968 patients, 128 had trochlear calcification (13%). No significant association was observed between diabetes mellitus and trochlear calcifications in patients of any age (P = .40). There was no significant correlation between trochlear calcifications and chronic kidney disease, alcoholism, endocrine disorders, or HIV infection. Statistically significant associations among trochlear calcification, autoimmune conditions, and elevated alkaline phosphatase levels were observed (P < .0001 and P < .0001, respectively). CONCLUSIONS On the basis of a large unrestricted population with thin-section CT imaging of the orbit, no significant association was observed between trochlear calcifications and diabetes mellitus. A statistically significant association was observed between trochlear calcification and autoimmune disease and elevated alkaline phosphatase levels.
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Affiliation(s)
- K Buch
- From the Departments of Radiology (K.B., R.N.N., A.D.T., A.F., O.S.)
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Yoon HJ, Son C, Lee S, Joo K, Kim TH. A Case of Retropharyngeal Calcific Tendinitis in a Patient with Ankylosing Spondylitis. JOURNAL OF RHEUMATIC DISEASES 2013. [DOI: 10.4078/jrd.2013.20.6.385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Hyae Jin Yoon
- Department of Internal Medicine, Hanyang University Collegy of Medicine, Seoul, Korea
| | - Changnam Son
- Department of Internal Medicine, Hanyang University Collegy of Medicine, Seoul, Korea
- Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Seoul, Korea
| | - Seunghun Lee
- Department of Radiology, Hanyang University Hospital for Rheumatic Diseases, Seoul, Korea
| | - Kungbin Joo
- Department of Radiology, Hanyang University Hospital for Rheumatic Diseases, Seoul, Korea
| | - Tae Hwan Kim
- Department of Internal Medicine, Hanyang University Collegy of Medicine, Seoul, Korea
- Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Seoul, Korea
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