A 38-Year-Old Man with an Exacerbation of Shoulder Pain

Differential Diagnosis

• Shoulder dislocation
• Hill Sachs deformity
• AC separation
• Calcific tendinitis
• Loose bodies

Diagnosis

This patient was diagnosed with calcific tendinitis of the rotator cuff, as noted by the 12 mm amorphous globular calcific density projecting over the superior aspect of the humeral head.

Learnings/What to Look For

• Calcific tendinitis of the rotator cuff is characterized by deposits of hydroxyapatite in the tendons of the rotator cuff, which can cause pain and inflammation
• Conservative therapy with NSAIDs and physical therapy is often sufficient
• Severe cases require surgical resection
• Calcific tendinitis can be treated in the urgent care setting unless there is diagnostic uncertainty, severe pain, or intractable pain—in which case referral to an orthopedist is warrante

Acknowledgment: Image and case provided by Experity Teleradiology (www.experityhealth.com/teleradiology).