ICD-10: M65.28

Calcific tendinitis, classified under ICD-10 code M65.28, is a condition characterized by the deposition of calcium salts in the tendons, leading to inflammation and pain. This condition can affect various tendons in the body, but it is most commonly seen in the shoulder, particularly the rotator cuff tendons. Understanding the clinical presentation, signs, symptoms, and patient characteristics associated with calcific tendinitis is crucial for effective diagnosis and management.

Clinical Presentation

Signs and Symptoms

Patients with calcific tendinitis typically present with a range of symptoms that can vary in intensity. Common signs and symptoms include:

• Localized Pain: Patients often report sharp, severe pain in the affected area, which may worsen with movement or pressure. In the shoulder, this pain can radiate down the arm or be felt in the neck[1].
• Swelling and Tenderness: There may be noticeable swelling and tenderness over the affected tendon, particularly during palpation[1][2].
• Limited Range of Motion: Patients frequently experience a reduced range of motion in the affected joint due to pain and inflammation. In shoulder cases, this can manifest as difficulty lifting the arm or performing overhead activities[2].
• Stiffness: Stiffness in the joint may occur, especially after periods of inactivity, leading to discomfort during initial movements[1].
• Crepitus: Some patients may report a sensation of grating or popping in the joint during movement, known as crepitus, which can be indicative of tendon involvement[2].

Patient Characteristics

Calcific tendinitis can affect individuals across various demographics, but certain characteristics are more commonly observed:

• Age: The condition is most prevalent in adults, particularly those aged 30 to 60 years. It is less common in younger individuals[1][3].
• Gender: There is a slight female predominance in cases of calcific tendinitis, particularly in the shoulder[3].
• Activity Level: Patients who engage in repetitive overhead activities or sports (e.g., swimming, tennis) may be at higher risk due to the increased strain on the shoulder tendons[2].
• Comorbidities: Individuals with certain comorbid conditions, such as diabetes or thyroid disorders, may have a higher incidence of calcific tendinitis. These conditions can affect calcium metabolism and tendon health[3][4].

Diagnosis

Diagnosis of calcific tendinitis typically involves a combination of clinical evaluation and imaging studies. Physicians may use:

• Physical Examination: A thorough physical examination to assess pain, tenderness, and range of motion.
• Imaging: X-rays are commonly used to visualize calcific deposits in the tendons. Ultrasound or MRI may also be employed for a more detailed assessment of tendon integrity and surrounding structures[1][4].

Conclusion

Calcific tendinitis, particularly coded as M65.28, presents with distinct clinical features, including localized pain, swelling, and limited range of motion, primarily affecting adults, especially those engaged in repetitive activities. Understanding these characteristics aids in timely diagnosis and appropriate management, which may include conservative treatments such as physical therapy, corticosteroid injections, or, in severe cases, surgical intervention. Early recognition and intervention are key to improving patient outcomes and restoring function.

Calcific tendinitis, classified under the ICD-10-CM code M65.28, refers to a condition characterized by the deposition of calcium salts in the tendons, leading to inflammation and pain. This condition can occur in various locations in the body, and understanding its alternative names and related terms can be beneficial for accurate diagnosis and treatment.

Alternative Names for Calcific Tendinitis

1. Calcific Tendonitis: This is a common alternative spelling of the term, often used interchangeably with calcific tendinitis.
2. Calcific Tendinopathy: This term emphasizes the degenerative aspect of the tendon condition, highlighting the chronic nature of the inflammation and calcium deposits.
3. Tendinitis with Calcification: This phrase describes the condition by focusing on the inflammation of the tendon accompanied by calcification.
4. Tendon Calcification: A more general term that refers to the presence of calcium deposits in any tendon, not limited to specific sites.

Related Terms

1. Tendinitis: A broader term that refers to inflammation of a tendon, which can occur without calcification.
2. Tendinopathy: This term encompasses a range of tendon disorders, including tendinitis and tendinosis, and can be used to describe conditions that may or may not involve calcification.
3. Shoulder Impingement Syndrome: Often associated with calcific tendinitis of the shoulder, this condition occurs when the rotator cuff tendons are compressed during shoulder movements.
4. Rotator Cuff Tendinitis: Specifically refers to inflammation of the rotator cuff tendons, which can be related to calcific deposits.
5. Bursitis: While not the same condition, bursitis can occur alongside calcific tendinitis, particularly in the shoulder, as both involve inflammation in the same region.

Conclusion

Understanding the alternative names and related terms for ICD-10 code M65.28 is crucial for healthcare professionals in accurately diagnosing and treating patients with calcific tendinitis. By recognizing these terms, practitioners can ensure better communication and documentation in clinical settings, ultimately leading to improved patient care.

Calcific tendinitis, classified under the ICD-10-CM code M65.28, refers to the condition where calcium deposits form in the tendons, leading to pain and inflammation. The diagnosis of calcific tendinitis involves several criteria, which can be categorized into clinical evaluation, imaging studies, and exclusion of other conditions.

Clinical Evaluation

1. Patient History:
   - The clinician will gather a detailed medical history, focusing on the onset, duration, and nature of the symptoms. Patients typically report localized pain, swelling, and sometimes limited range of motion in the affected area.

2. Physical Examination:
   - A thorough physical examination is conducted to assess tenderness, swelling, and any signs of inflammation in the affected tendon. The clinician may also evaluate the range of motion and strength of the surrounding muscles.

Imaging Studies

1. X-rays:
   - X-rays are often the first imaging modality used to identify calcific deposits in the tendons. The presence of calcifications in the tendon is a key indicator of calcific tendinitis.

2. Ultrasound:
   - Ultrasound can provide real-time imaging of the tendon and surrounding structures, helping to visualize the size and location of the calcific deposits. It can also assess the degree of inflammation.

3. MRI:
   - Magnetic Resonance Imaging (MRI) may be utilized in complex cases to evaluate the extent of tendon damage and to rule out other potential causes of pain, such as tears or other inflammatory conditions.

Exclusion of Other Conditions

1. Differential Diagnosis:
   - It is crucial to differentiate calcific tendinitis from other conditions that may present similarly, such as rotator cuff tears, bursitis, or other forms of tendinopathy. This may involve additional imaging or diagnostic tests.

2. Laboratory Tests:
   - While not routinely required, laboratory tests may be performed to rule out systemic conditions that could contribute to tendon inflammation, such as rheumatoid arthritis or metabolic disorders.

Conclusion

The diagnosis of calcific tendinitis (ICD-10 code M65.28) is primarily based on a combination of clinical evaluation, imaging studies, and the exclusion of other potential conditions. Accurate diagnosis is essential for effective treatment planning, which may include conservative management, physical therapy, or, in some cases, surgical intervention. If you have further questions or need more specific information, feel free to ask!

Calcific tendinitis, classified under ICD-10 code M65.28, is a condition characterized by the deposition of calcium salts in the tendons, often leading to pain and inflammation. This condition can affect various sites in the body, most commonly the shoulder, but it can also occur in other areas such as the hip, knee, and wrist. The treatment approaches for calcific tendinitis typically aim to relieve pain, reduce inflammation, and restore function. Here’s a detailed overview of standard treatment strategies:

Conservative Treatment Options

1. Rest and Activity Modification

• Rest: Patients are often advised to rest the affected area to prevent further irritation and allow healing.
• Activity Modification: Adjusting daily activities to avoid movements that exacerbate pain can be beneficial.

2. Physical Therapy

• Therapeutic Exercises: A physical therapist may design a program that includes stretching and strengthening exercises to improve range of motion and support the affected tendon.
• Ultrasound Therapy: This modality can help reduce pain and inflammation and promote healing by increasing blood flow to the area.

3. Medications

• Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): Over-the-counter medications like ibuprofen or naproxen can help alleviate pain and reduce inflammation.
• Corticosteroids: In some cases, a doctor may prescribe corticosteroid injections to provide more significant relief from inflammation.

Interventional Treatments

4. Extracorporeal Shock Wave Therapy (ESWT)

• This non-invasive treatment uses acoustic waves to promote healing in the affected tendon and can help reduce pain associated with calcific tendinitis. Studies have shown ESWT to be effective in managing symptoms and improving function in patients with this condition[6].

5. Needle Aspiration and Injection

• Needle Aspiration: In cases where calcific deposits are significant, a physician may use a needle to aspirate the calcium deposits directly from the tendon.
• Injection of Corticosteroids or Hyaluronic Acid: Following aspiration, injecting corticosteroids can help reduce inflammation, while hyaluronic acid may improve joint lubrication.

Surgical Options

6. Surgical Intervention

• If conservative treatments fail to provide relief after several months, surgical options may be considered. The most common procedure is arthroscopic surgery, where the surgeon removes the calcific deposits and repairs any damaged tendon tissue. This approach is generally effective in alleviating pain and restoring function[6].

Conclusion

The management of calcific tendinitis (ICD-10 code M65.28) typically begins with conservative measures, including rest, physical therapy, and medications. If these approaches do not yield satisfactory results, interventional treatments such as ESWT or needle aspiration may be employed. In persistent cases, surgical intervention may be necessary to remove calcific deposits and repair the affected tendon. It is essential for patients to work closely with their healthcare providers to determine the most appropriate treatment plan based on the severity of their condition and individual health needs.

Calcific tendinitis, classified under ICD-10 code M65.28, refers to a condition characterized by the deposition of calcium salts in the tendons, leading to inflammation and pain. This condition can occur in various tendons throughout the body, but it is most commonly associated with the shoulder, particularly the rotator cuff tendons. Below is a detailed overview of the clinical description, symptoms, diagnosis, and treatment options for calcific tendinitis.

Clinical Description

Definition

Calcific tendinitis is an inflammatory condition resulting from the accumulation of calcium hydroxyapatite crystals within the tendon. This process can lead to significant pain and functional impairment, particularly in the affected area. The term "other site" in the ICD-10 code M65.28 indicates that the calcific deposits can occur in tendons other than those typically associated with the shoulder, such as the hip, knee, or wrist.

Etiology

The exact cause of calcific tendinitis remains unclear, but several factors may contribute to its development, including:
- Age: It is more prevalent in individuals aged 30 to 60 years.
- Gender: Women are more frequently affected than men.
- Overuse: Repetitive motions or overuse of a tendon can increase the risk.
- Metabolic disorders: Conditions such as diabetes or thyroid disorders may predispose individuals to calcific deposits.

Symptoms

Patients with calcific tendinitis typically experience:
- Localized pain: This pain is often sharp and can worsen with movement or pressure on the affected tendon.
- Swelling and tenderness: The area around the tendon may appear swollen and tender to touch.
- Limited range of motion: Patients may find it difficult to move the affected joint due to pain and stiffness.
- Night pain: Discomfort may worsen at night, affecting sleep quality.

Diagnosis

Clinical Evaluation

Diagnosis of calcific tendinitis involves a thorough clinical evaluation, including:
- Medical history: A detailed history of symptoms, including onset, duration, and aggravating factors.
- Physical examination: Assessment of tenderness, swelling, and range of motion in the affected area.

Imaging Studies

Imaging techniques are crucial for confirming the diagnosis:
- X-rays: These can reveal calcific deposits within the tendon.
- Ultrasound: This imaging modality can provide real-time visualization of the tendon and surrounding structures, helping to assess the extent of calcification and inflammation.
- MRI: In some cases, MRI may be used to evaluate soft tissue involvement and rule out other conditions.

Treatment Options

Conservative Management

Initial treatment typically involves conservative measures, including:
- Rest: Avoiding activities that exacerbate symptoms.
- Ice therapy: Applying ice packs to reduce swelling and pain.
- Nonsteroidal anti-inflammatory drugs (NSAIDs): Medications such as ibuprofen or naproxen can help alleviate pain and inflammation.

Physical Therapy

Physical therapy may be recommended to improve range of motion and strengthen the surrounding muscles. Techniques may include:
- Stretching exercises: To enhance flexibility.
- Strengthening exercises: To support the affected tendon.

Invasive Treatments

If conservative management fails, more invasive options may be considered:
- Corticosteroid injections: These can provide temporary relief from inflammation and pain.
- Extracorporeal shock wave therapy (ESWT): This non-invasive treatment uses sound waves to break down calcific deposits.
- Surgical intervention: In severe cases, surgical removal of the calcific deposits may be necessary.

Conclusion

Calcific tendinitis, coded as M65.28 in the ICD-10 classification, is a painful condition resulting from calcium deposits in tendons, leading to inflammation and functional limitations. Early diagnosis and a comprehensive treatment plan, including conservative management and physical therapy, are essential for effective recovery. In cases where conservative measures are insufficient, more invasive treatments may be warranted to alleviate symptoms and restore function. Understanding the clinical aspects of this condition can aid healthcare providers in delivering appropriate care and improving patient outcomes.