Endoscopic Treatment of Calcific Tendinitis of the Gluteus Maximus: A Case Report

Calcific Tendinopathy Atypically Located Outside the Rotator Cuff: A Systematic Review

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.

Endoscopic treatment for calcific tendinitis of the gluteus medius: A case report and review

Tendon calcification is a common disease, with the shoulder rotator cuff being the most common site. However, calcific tendinitis of the gluteus medius has rarely been reported. This study reports the case of a 64-year-old woman diagnosed with calcific tendinitis of the gluteus medius and experiencing right lateral hip pain with no apparent trigger. After unsuccessful conservative treatment, hip endoscopy was performed on this patient, allowing for a clear view of a “toothpaste-like” lesion in the gluteus medius tendon. A shaver was used to remove the lesion. After 8 weeks and 14 months of follow-up, the patient could return to regular daily and social activities. This study shows that endoscopic surgery can lead to effective, rapid recovery and minimally invasive clinical outcomes in patients with tendon calcification near the hip joint.