Aunt Liu, 50 years old this year, recently suffered from severe pain in her right shoulder, and her entire right arm felt swollen and painful. She even woke up from the pain when sleeping at night. Under the shadow of severe pain, Aunt Liu did not dare to move her right arm, and she was frightened all day long. .
In order to seek diagnosis and treatment, Aunt Liu came to the Orthopedic and Joint Clinic of Hunan Provincial Second People's Hospital. Deputy Chief Physician Chai Zhiyong received the patient. After a simple examination and X-ray examination, Aunt Liu was diagnosed with " calcific Tendinitis ”.
According to Dr. Chai Zhiyong, the main cause of Aunt Liu's illness is the deposition of calcified material in the supraspinatus tendon of the shoulder, causing recurring inflammation. Calcific tendonitis usually occurs between the ages of 40 and 50, and is mainly characterized by limited joint movement and severe pain. The formation of calcified lesions goes through three different stages: in the pre-calcification stage, there are mainly calcium salt depositions with few clinical symptoms; in the calcification stage, calcium deposits gradually appear in the cells of the lesions, and when calcification lesions begin to reabsorb, it will induce obvious Pain is accompanied by limited movement, and often occurs at night, and patients are suddenly awakened by pain in their sleep; in the later stages of calcification, calcium deposits are absorbed, tendon tissue is repaired, and some patients' pain is significantly reduced or even disappeared.
After further hospitalization examination and treatment, Aunt Liu’s calcific tendonitis has become more serious. The conservative treatment effect is poor and the calcification area is large, which has seriously affected her functional activities, sleep, etc. Under the doctor’s advice, Aunt Liu successfully accepted the treatment. Arthroscopic calcification removal + rotator cuff suturing surgery. The operation went smoothly. On the second day after the operation, Aunt Liu's shoulder pain was significantly relieved, and on the third day after the operation, the shoulder joint could move freely.
△ During the operation, white "toothpaste" spurted out from the tendon
It is worth noting that a "magical" scene occurred during the operation. Chief Physician Li Baojun, who performed arthroscopic surgery on Aunt Liu, said that when the tendon calcification was gently opened with a probe hook, a large amount of "toothpaste"-like white substance immediately spurted out from the tendon. In fact, this was incomplete calcification deposition. Due to the release of calcification lesions, the white ejection material is the home base of calcific tendonitis.
Director Li Baojun reminded that because the symptoms of calcific tendinitis and frozen shoulder are somewhat similar, many people mistakenly think that they have frozen shoulder and throw their arms hard. In fact, this is the wrong way to exercise because the calcification lesions are in the Within the tendon, overstimulation may lead to tears in the already fragile supraspinatus tendon, leading to functional impairment. Others think that they can get over it if they just tolerate it, which often leads to delays in treatment.
So how to accurately identify whether you have calcific tendonitis? Director Li Baojun pointed out that a simple X-ray examination only costs tens of dollars. If it is a calcification foci, there will be high-density white development on the X-ray. It is easier to diagnose based on clinical manifestations.
Does calcific tendonitis require immediate surgical treatment once it is diagnosed? Director Li Baojun explained that calcific tendonitis is a self-limiting disease, that is, some patients can recover on their own after the disease develops to a certain extent. Under normal circumstances, patients with shoulder pain that are not obvious can adopt conservative treatment. Conservative treatment methods include rest, oral non-steroidal anti-inflammatory and analgesic drugs, physical therapy, functional exercise and application of hormones. If conservative treatment is ineffective and the patient's activities are limited, the pain is unbearable, and the quality of life is seriously affected, shoulder arthroscopy may be considered to find the calcification lesions, remove them, and repair the rotator cuff according to the size of the calcification lesions. Maintaining the integrity of the rotator cuff will provide a better treatment effect.
Experts remind that shoulder joints are susceptible to calcific tendonitis, and the prevalence increases with age. Shoulder pain does not necessarily mean frozen shoulder. Early diagnosis, early treatment, and early intervention of shoulder pain are crucial.
Xiaoxiang Morning News reporter Xia Sheng and correspondent Dai Jinjun
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