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AJR Am J Roentgenol. 2003 Oct;181(4):965-72.

Osseous involvement in calcific tendinitis: a retrospective review of 50 cases.

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  • 1Department of Radiology, National Naval Medical Center, 8901 Wisconsin Ave., Bethesda, MD 20889, USA.

Abstract

OBJECTIVE:

The purpose of this study was to describe the spectrum of radiologic and pathologic manifestations of calcific tendinitis involving bone.

MATERIALS AND METHODS:

We retrospectively reviewed 50 cases of calcific tendinitis involving underlying bone. Clinical data reviewed included patient age and sex and lesion location. Images reviewed included radiographs (n = 44), CT scans (n = 13), MRIs (n = 16), and bone scintigrams (n = 13). Radiologic examinations were evaluated for the presence of cortical erosion, periosteal reaction, and marrow extension. Pathology confirmation was available in 37 cases.

RESULTS:

The average age of patients was 50 years (range, 16-82 years), with 29 female patients (58%). Calcific tendinitis with associated bone involvement was seen most commonly in the femur (40%) and the humerus (40%). Concretions were most commonly solid-appearing (50%). Cortical erosion was the most common manifestation of osseous involvement (78% of cases). Marrow involvement was shown in 18 (36%) of 50 cases. Marrow extension was most commonly seen in the lesser and greater tuberosities of the humerus, which accounted for 61% (11/18) of cases. Focal increased radionuclide uptake was seen in 13 (100%) of 13 cases.

CONCLUSION:

Calcific tendinitis presenting with osseous destruction, marrow changes, and soft-tissue calcifications may be confused with neoplasm both radiologically and pathologically. Recognition of the atypical presentation of this common disease may prevent unnecessary biopsy.

PMID:
14500211
[PubMed - indexed for MEDLINE]
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