ICD-10: M65.29

Calcific tendinitis, classified under ICD-10 code M65.29, is a condition characterized by the deposition of calcium salts in the tendons, often leading to pain and inflammation. This condition can affect multiple sites, commonly the shoulder, and is typically seen in individuals aged 30 to 60. The treatment approaches for calcific tendinitis focus on alleviating pain, reducing inflammation, and restoring function. Here’s a detailed overview of standard treatment strategies.

Conservative Management

1. Rest and Activity Modification

• Rest: Patients are advised to rest the affected area to prevent exacerbation of symptoms. Avoiding activities that provoke pain is crucial.
• Activity Modification: Gradually returning to normal activities while avoiding repetitive overhead motions can help manage symptoms.

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.
• Manual Therapy: Techniques such as joint mobilization and soft tissue manipulation can alleviate pain and improve function.

3. Medications

• Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): Over-the-counter medications like ibuprofen or naproxen can help reduce pain and inflammation.
• Corticosteroid Injections: In cases of severe pain, corticosteroid injections may be administered to provide temporary relief.

Advanced Interventions

4. Extracorporeal Shock Wave Therapy (ESWT)

• This non-invasive treatment uses acoustic waves to promote healing in the affected tendon. Studies have shown ESWT to be effective in reducing pain and improving function in patients with calcific tendinitis[8].

5. Ultrasound-Guided Needle Aspiration

• In cases where conservative treatments fail, ultrasound-guided needle aspiration can be performed to remove calcium deposits. This procedure can provide significant pain relief and improve mobility.

6. Surgery

• Arthroscopic Surgery: If conservative measures do not yield results, surgical intervention may be necessary. Arthroscopy allows for direct visualization and removal of calcific deposits from the tendon. This minimally invasive procedure typically results in quicker recovery times compared to open surgery.

Post-Treatment Rehabilitation

7. Rehabilitation Program

• After any intervention, a structured rehabilitation program is essential. This may include continued physical therapy to restore strength and flexibility, as well as education on proper body mechanics to prevent recurrence.

Conclusion

The management of calcific tendinitis (ICD-10 code M65.29) typically begins with conservative approaches, including rest, physical therapy, and medications. For patients who do not respond to these treatments, advanced options like ESWT or surgical intervention may be considered. A comprehensive rehabilitation program post-treatment is crucial for optimal recovery and prevention of future episodes. As always, treatment should be tailored to the individual patient’s needs, and ongoing communication with healthcare providers is essential for effective management.

Calcific tendinitis, classified under ICD-10 code M65.29, refers to a condition characterized by the deposition of calcium salts in the tendons, often leading to inflammation and pain. This condition can affect multiple sites, commonly involving the shoulder, but it can also occur in other areas such as the hip, knee, and wrist. Understanding the clinical presentation, signs, symptoms, and patient characteristics associated with this condition 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. The pain can be sudden in onset and may be described as throbbing or aching.
• Swelling and Tenderness: The affected tendon may exhibit swelling and tenderness upon palpation. This is particularly noticeable in the shoulder region, where the rotator cuff tendons are commonly involved.
• Limited Range of Motion: Patients may experience restricted movement in the affected joint due to pain and inflammation. For instance, shoulder mobility can be significantly impaired, affecting daily activities.
• Crepitus: A sensation of grating or crackling may be felt during movement of the affected joint, which can be indicative of tendon involvement.
• Night Pain: Many patients report that pain intensifies at night, disrupting sleep and leading to further discomfort.

Patient Characteristics

Certain demographic and clinical characteristics are often observed in patients with calcific tendinitis:

• Age: This condition is more prevalent in adults, particularly those aged 30 to 60 years. The incidence tends to increase with age, likely due to degenerative changes in the tendons.
• Gender: There is a slight female predominance in cases of calcific tendinitis, especially in the shoulder.
• 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.
• 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.

Diagnosis

The diagnosis of calcific tendinitis typically involves a combination of clinical evaluation and imaging studies.

• Physical Examination: A thorough physical examination is essential to assess pain, tenderness, and range of motion in the affected area.
• Imaging: X-rays are commonly used to confirm the presence of calcific deposits in the tendons. Ultrasound and MRI may also be utilized for a more detailed assessment of the soft tissues and to evaluate the extent of inflammation.

Conclusion

Calcific tendinitis, particularly when affecting multiple sites, presents with distinct clinical features that can significantly impact a patient's quality of life. Recognizing the signs and symptoms, along with understanding patient characteristics, is vital for healthcare providers to facilitate timely diagnosis and appropriate management strategies. Treatment options may include conservative measures such as physical therapy, corticosteroid injections, and, in some cases, surgical intervention to remove calcific deposits if conservative management fails.

Calcific tendinitis, particularly when classified under the ICD-10 code M65.29, refers to a condition characterized by the deposition of calcium salts in the tendons, leading to inflammation and pain. This condition can affect multiple sites in the body, and it is often associated with various alternative names and related terms. Below is a detailed overview of these terms.

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 disease.
3. Calcium Deposits in Tendons: A descriptive term that refers to the accumulation of calcium in the tendon tissues, which is the underlying issue in calcific tendinitis.
4. Tendinitis with Calcification: This term specifies the presence of inflammation in the tendons along with calcification.
5. Tendon Calcification: A more general term that refers to the calcification process occurring in any tendon, not limited to inflammation.

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 in a more general context.
3. Rotator Cuff Tendinitis: Often associated with calcific tendinitis in the shoulder, this term specifies the location and type of tendon affected.
4. Shoulder Impingement Syndrome: This condition can be related to calcific tendinitis in the shoulder, where the tendons become irritated and inflamed due to impingement.
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.

Clinical Context

Calcific tendinitis is most commonly seen in the shoulder but can also affect other areas such as the elbow, wrist, and hip. The condition is often diagnosed through imaging techniques like X-rays or ultrasound, which can reveal the presence of calcium deposits. Treatment typically involves conservative measures such as physical therapy, anti-inflammatory medications, and in some cases, injections or surgery if conservative treatments fail.

Understanding these alternative names and related terms can help healthcare professionals communicate more effectively about the condition and ensure accurate diagnosis and treatment.

Calcific tendinitis, classified under ICD-10 code M65.29, refers to the condition characterized by the deposition of calcium salts in the tendons, leading to inflammation and pain. This condition can affect multiple sites in the body, commonly involving the shoulder, hip, and other joints. The diagnosis of calcific tendinitis typically involves several criteria, which can be categorized into clinical evaluation, imaging studies, and exclusion of other conditions.

Clinical Evaluation

1. Patient History:
   - Patients often report a history of pain and stiffness in the affected area, which may worsen with activity. The pain can be acute or chronic and is usually localized to the tendon involved.
   - A history of repetitive use or trauma to the affected joint may also be noted.

2. Physical Examination:
   - Tenderness over the affected tendon is a key indicator. The physician may assess for swelling, warmth, and range of motion limitations.
   - Specific tests may be performed to elicit pain, such as impingement tests for shoulder involvement.

Imaging Studies

1. X-rays:
   - X-rays are the primary imaging modality used to confirm the diagnosis. They can reveal calcific deposits within the tendon, which are typically visible as white spots on the X-ray.
   - The presence of calcifications in the rotator cuff tendons is a common finding in shoulder calcific tendinitis.

2. Ultrasound:
   - Ultrasound can be used to visualize the calcific deposits and assess the extent of inflammation in the surrounding tissues.
   - It is also helpful in guiding injections or aspirations if needed.

3. MRI:
   - While not always necessary, MRI can provide detailed images of soft tissues and may be used to evaluate the extent of tendon damage or to rule out other 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 arthritis.
   - A thorough assessment of the patient's symptoms and imaging findings helps in ruling out these alternative diagnoses.

2. Laboratory Tests:
   - Although not routinely required, blood tests may be performed to rule out systemic conditions that could contribute to tendon pain, such as inflammatory arthritis.

Conclusion

The diagnosis of calcific tendinitis (ICD-10 code M65.29) is primarily based on a combination of clinical evaluation, imaging studies, and the exclusion of other potential causes of tendon pain. Accurate diagnosis is essential for effective management, which may include conservative treatments such as physical therapy, anti-inflammatory medications, or, in some cases, surgical intervention if conservative measures fail. Understanding these criteria can aid healthcare professionals in providing appropriate care for patients suffering from this condition.

Clinical Description of ICD-10 Code M65.29: Calcific Tendinitis, Multiple Sites

Overview of Calcific Tendinitis

Calcific tendinitis is a condition characterized by the deposition of calcium salts in the tendons, most commonly affecting the shoulder, but it can also occur in other areas such as the hip, knee, and wrist. This condition often leads to inflammation, pain, and restricted movement in the affected joint. The exact cause of calcific tendinitis is not fully understood, but it is believed to be related to tendon degeneration and may be influenced by factors such as age, repetitive motion, and certain metabolic disorders.

ICD-10 Code M65.29

The ICD-10 code M65.29 specifically refers to "Calcific tendinitis, multiple sites." This code is used to classify cases where calcific deposits are present in more than one tendon or site within the body. It is important for healthcare providers to accurately document this condition for proper diagnosis, treatment, and billing purposes.

Clinical Features

1. Symptoms:
   - Pain: Patients typically experience localized pain in the affected areas, which may worsen with movement or pressure.
   - Swelling: Inflammation around the tendon can lead to noticeable swelling.
   - Limited Range of Motion: Patients may find it difficult to move the affected joint due to pain and stiffness.
   - Tenderness: The area around the tendon may be tender to touch.

2. Common Sites:
   - While calcific tendinitis can occur in various locations, the most frequently affected sites include:

   • Shoulder: Often referred to as calcific shoulder tendinitis.
   • Hip: Involvement of the hip tendons can lead to significant discomfort.
   • Knee and Wrist: Less common but still possible sites for calcific deposits.

3. Diagnosis:
   - Diagnosis typically involves a combination of clinical evaluation and imaging studies. X-rays are commonly used to visualize calcific deposits, while ultrasound or MRI may be employed for a more detailed assessment of the tendon and surrounding structures.

Treatment Options

Treatment for calcific tendinitis, particularly when it affects multiple sites, may include:

• Conservative Management:
• Rest: Avoiding activities that exacerbate symptoms.
• Physical Therapy: Exercises to improve range of motion and strengthen surrounding muscles.

• Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) to reduce pain and inflammation.

• Interventional Procedures:

• Corticosteroid Injections: To alleviate inflammation and pain.
• Extracorporeal Shock Wave Therapy: A non-invasive treatment that may help dissolve calcium deposits.
• Surgical Intervention: In severe cases, surgery may be necessary to remove calcific deposits.

Conclusion

ICD-10 code M65.29 is essential for accurately identifying and managing calcific tendinitis affecting multiple sites. Understanding the clinical features, diagnostic methods, and treatment options is crucial for healthcare providers to deliver effective care. Proper coding not only aids in treatment planning but also ensures appropriate reimbursement for services rendered. As with any medical condition, early diagnosis and intervention can significantly improve patient outcomes and quality of life.