ICD-10: M75.3

Calcific tendinitis of the shoulder, classified under ICD-10 code M75.3, is a common condition characterized by the deposition of calcium salts in the tendons of the shoulder, particularly affecting the rotator cuff. This condition can lead to significant pain and functional impairment, making it a notable concern in orthopedic practice.

Clinical Description

Pathophysiology

Calcific tendinitis typically occurs when calcium hydroxyapatite crystals accumulate in the rotator cuff tendons, most often in the supraspinatus tendon. The exact cause of this calcium deposition is not fully understood, but it is believed to be related to degenerative changes in the tendon, possibly exacerbated by repetitive shoulder use or trauma. The condition can be classified into three stages:

1. Pre-calcific Stage: This initial phase involves tendon degeneration without calcium deposits.
2. Calcific Stage: This stage is marked by the formation of calcium deposits, which can be asymptomatic or cause significant pain.
3. Post-calcific Stage: In this final phase, the calcium deposits may resorb, leading to a reduction in symptoms and improvement in shoulder function.

Symptoms

Patients with calcific tendinitis often present with:
- Shoulder Pain: Typically localized to the lateral aspect of the shoulder, which may radiate down the arm.
- Limited Range of Motion: Difficulty in performing overhead activities or reaching behind the back.
- Night Pain: Discomfort that worsens at night, often disrupting sleep.
- Swelling and Tenderness: Localized tenderness over the affected area, particularly during palpation.

Diagnosis

Diagnosis is primarily clinical, supported by imaging studies. Key diagnostic tools include:
- X-rays: These can reveal calcific deposits in the rotator cuff tendons.
- Ultrasound: Useful for assessing the size and location of calcifications and evaluating tendon integrity.
- MRI: Provides detailed images of soft tissues and can help rule out other shoulder pathologies.

Treatment Options

Conservative Management

Most cases of calcific tendinitis respond well to conservative treatment, which may include:
- Rest and Activity Modification: Avoiding activities that exacerbate symptoms.
- Physical Therapy: Exercises to improve range of motion and strengthen shoulder muscles.
- Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): To reduce pain and inflammation.
- Corticosteroid Injections: May be administered to alleviate severe pain.

Surgical Intervention

If conservative measures fail after several months, surgical options may be considered, including:
- Arthroscopic Removal: Minimally invasive procedure to remove calcific deposits.
- Open Surgery: In more complex cases, open surgery may be necessary to address the condition.

Prognosis

The prognosis for calcific tendinitis is generally favorable, with many patients experiencing significant improvement with appropriate treatment. However, some may develop chronic pain or recurrent symptoms, necessitating further intervention.

Conclusion

ICD-10 code M75.3 encapsulates a prevalent condition that can significantly impact shoulder function and quality of life. Understanding its clinical presentation, diagnostic approach, and treatment options is essential for effective management. Early intervention and a tailored treatment plan can lead to favorable outcomes for patients suffering from calcific tendinitis of the shoulder.

Calcific tendinitis of the shoulder, classified under ICD-10 code M75.3, is a common condition characterized by the deposition of calcium salts in the rotator cuff tendons, particularly the supraspinatus tendon. This condition can lead to significant pain and functional impairment. Below is a detailed overview of its clinical presentation, signs, symptoms, and patient characteristics.

Clinical Presentation

Overview

Calcific tendinitis typically presents with acute shoulder pain, often exacerbated by movement. The condition can be classified into two phases: the formative phase, where calcium deposits accumulate, and the resorptive phase, where the body begins to break down these deposits. Patients may experience varying degrees of pain and functional limitations depending on the phase of the condition.

Signs and Symptoms

1. Pain:
   - Patients often report sudden onset of severe shoulder pain, which may radiate down the arm or into the neck. The pain is usually localized to the lateral aspect of the shoulder and can be exacerbated by overhead activities or lifting[1].
   - Pain may be constant or intermittent, often worsening at night or with specific movements.

2. Limited Range of Motion:
   - Affected individuals typically exhibit restricted range of motion, particularly in abduction and external rotation. This limitation can be due to pain or mechanical blockage from the calcific deposits[2].

3. Tenderness:
   - Physical examination often reveals tenderness over the greater tuberosity of the humerus and the subacromial space. Palpation may elicit pain, particularly when the arm is raised[3].

4. Swelling and Inflammation:
   - In some cases, there may be visible swelling or signs of inflammation around the shoulder joint, although this is less common[4].

5. Muscle Weakness:
   - Patients may demonstrate weakness in shoulder abduction and external rotation due to pain and disuse, which can further limit functional activities[5].

Patient Characteristics

1. Demographics:
   - Calcific tendinitis is more prevalent in individuals aged 30 to 60 years, with a higher incidence in women compared to men[6].
   - It is often associated with occupations or activities that involve repetitive overhead motions, such as athletes, painters, and construction workers[7].

2. Comorbidities:
   - Patients may have a history of shoulder injuries or other shoulder pathologies, such as rotator cuff tears or adhesive capsulitis. Additionally, conditions like diabetes and thyroid disorders have been linked to an increased risk of calcific tendinitis[8].

3. Lifestyle Factors:
   - Sedentary lifestyle or lack of shoulder conditioning can contribute to the development of this condition. Conversely, individuals engaged in high levels of physical activity may also be at risk due to repetitive strain on the shoulder[9].

Conclusion

Calcific tendinitis of the shoulder (ICD-10 code M75.3) is characterized by acute shoulder pain, limited range of motion, and tenderness, primarily affecting middle-aged adults. Understanding the clinical presentation and patient characteristics is crucial for accurate diagnosis and effective management. Treatment options may include physical therapy, corticosteroid injections, and, in some cases, surgical intervention to remove the calcific deposits. Early recognition and intervention can significantly improve patient outcomes and restore shoulder function.

Calcific tendinitis of the shoulder, classified under ICD-10 code M75.3, is a condition characterized by the deposition of calcium salts in the rotator cuff tendons, leading to pain and restricted movement. This condition is often associated with various alternative names and related terms that can help in understanding its clinical context and implications. Below are some of the most common alternative names and related terms for M75.3:

Alternative Names

1. Calcific Tendonitis: This term is frequently used interchangeably with calcific tendinitis, emphasizing the inflammatory aspect of the condition.
2. Shoulder Calcific Tendinitis: A more specific term that highlights the location of the condition.
3. Calcific Shoulder Tendinopathy: This term reflects the degenerative changes in the tendon associated with calcification.
4. Rotator Cuff Calcific Tendinitis: This name specifies the involvement of the rotator cuff tendons, which are commonly affected in this condition.

Related Terms

1. Shoulder Pain: A general term that encompasses the symptom experienced by patients with calcific tendinitis.
2. Tendinitis: A broader term that refers to inflammation of a tendon, which can occur in various locations, not just the shoulder.
3. Tendinopathy: This term refers to any disease of a tendon, including degenerative changes and inflammation.
4. Subacromial Impingement Syndrome: This condition can be related to calcific tendinitis, as the calcium deposits may cause impingement of the rotator cuff tendons under the acromion.
5. Rotator Cuff Injury: While not synonymous, calcific tendinitis can be a type of rotator cuff injury, leading to similar symptoms and treatment approaches.

Clinical Context

Calcific tendinitis is often diagnosed through imaging techniques such as X-rays or ultrasound, which can reveal the presence of calcium deposits in the affected tendons. Treatment typically involves conservative measures such as physical therapy, anti-inflammatory medications, and in some cases, corticosteroid injections or surgical intervention if conservative management fails.

Understanding these alternative names and related terms can aid healthcare professionals in accurately diagnosing and discussing the condition with patients, as well as in coding for insurance and medical records purposes.

Calcific tendinitis of the shoulder, classified under ICD-10 code M75.3, is a condition characterized by the deposition of calcium salts in the rotator cuff tendons, leading to pain and restricted movement. The diagnosis of calcific tendinitis typically involves a combination of clinical evaluation and imaging studies. Below are the key criteria used for diagnosis:

Clinical Criteria

1. Patient History:
   - Patients often report a history of shoulder pain, which may be acute or chronic. The pain is usually localized to the shoulder and can radiate down the arm.
   - Symptoms may include stiffness, weakness, and difficulty with overhead activities.

2. Physical Examination:
   - Tenderness over the affected shoulder, particularly around the rotator cuff area.
   - Limited range of motion, especially in abduction and external rotation.
   - Positive impingement signs, such as the Neer or Hawkins-Kennedy tests, indicating potential rotator cuff involvement.

Imaging Studies

1. X-rays:
   - X-rays are the primary imaging modality used to confirm the diagnosis. They can reveal calcific deposits in the rotator cuff tendons, typically located in the supraspinatus tendon.
   - The presence of calcifications can vary in size and may appear as dense white spots on the X-ray.

2. Ultrasound:
   - Ultrasound can be used to visualize calcific deposits and assess the condition of the rotator cuff tendons. It is particularly useful for guiding injections or aspirations if needed.

3. MRI:
   - While not always necessary, MRI can provide detailed images of the shoulder's soft tissues, helping to evaluate the extent of tendon damage and any associated conditions, such as tears or bursitis.

Differential Diagnosis

It is essential to differentiate calcific tendinitis from other shoulder conditions, such as:
- Rotator cuff tears
- Bursitis
- Osteoarthritis
- Adhesive capsulitis (frozen shoulder)

Conclusion

The diagnosis of calcific tendinitis of the shoulder (ICD-10 code M75.3) relies on a thorough clinical assessment combined with imaging studies to confirm the presence of calcifications and rule out other shoulder pathologies. Accurate diagnosis is crucial for determining the appropriate treatment plan, which may include conservative management, physical therapy, or, in some cases, surgical intervention.

Calcific tendinitis of the shoulder, classified under ICD-10 code M75.3, is a condition characterized by the accumulation of calcium deposits in the rotator cuff tendons, leading to pain and restricted mobility. The treatment approaches for this condition can vary based on the severity of symptoms and the impact on daily activities. Below is a comprehensive overview of standard treatment strategies.

Conservative Treatment Options

1. Physical Therapy

Physical therapy is often the first line of treatment for calcific tendinitis. A physical therapist can design a tailored exercise program aimed at:
- Improving Range of Motion: Gentle stretching and mobility exercises can help restore movement in the shoulder joint.
- Strengthening Muscles: Strengthening exercises for the shoulder and surrounding muscles can provide better support and reduce strain on the affected tendon.
- Pain Management: Techniques such as ultrasound therapy, electrical stimulation, and manual therapy may be employed to alleviate pain and inflammation[1][2].

2. Medications

Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly prescribed to manage pain and reduce inflammation. Over-the-counter options like ibuprofen or naproxen can be effective, while stronger prescription medications may be necessary for more severe pain[1][3].

3. Corticosteroid Injections

In cases where pain is significant and does not respond to oral medications, corticosteroid injections may be administered directly into the shoulder joint. These injections can provide temporary relief by reducing inflammation around the calcium deposits[2][4].

4. Activity Modification

Patients are often advised to modify their activities to avoid exacerbating the condition. This may include:
- Avoiding Overhead Activities: Limiting movements that require lifting the arm above shoulder level can help reduce pain.
- Resting the Shoulder: Allowing time for the shoulder to rest can facilitate healing and reduce inflammation[3][5].

Advanced Treatment Options

1. Extracorporeal Shock Wave Therapy (ESWT)

Extracorporeal shock wave therapy is a non-invasive treatment that uses acoustic waves to promote healing in the affected tendon. This therapy can help reduce pain and improve function in patients with calcific tendinitis[1][5].

2. Needle Aspiration and Lavage

In some cases, a physician may recommend needle aspiration to remove calcium deposits. This procedure involves using a needle to draw out the calcium and may be performed under ultrasound guidance. Following aspiration, saline may be injected to wash out the area, which can help alleviate symptoms[2][4].

3. Surgery

If conservative treatments fail to provide relief after several months, surgical intervention may be considered. The surgical options include:
- Arthroscopic Surgery: This minimally invasive procedure allows the surgeon to remove calcium deposits and repair any damaged tendons.
- Open Surgery: In more severe cases, open surgery may be necessary to access the shoulder joint and perform repairs[3][5].

Conclusion

The management of calcific tendinitis of the shoulder (ICD-10 code M75.3) typically begins with conservative treatments, including physical therapy, medications, and activity modifications. For patients who do not respond to these approaches, advanced options such as shock wave therapy, needle aspiration, or surgery may be considered. It is essential for patients to work closely with their healthcare providers to determine the most appropriate treatment plan based on their specific symptoms and lifestyle needs. Regular follow-up and reassessment are crucial to ensure optimal recovery and function of the shoulder.