ICD-10: M75.31

Calcific tendinitis of the right shoulder, classified under ICD-10 code M75.31, is a 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 common diagnosis in orthopedic practice.

Clinical Description

Pathophysiology

Calcific tendinitis occurs when calcium hydroxyapatite crystals accumulate in the tendons, most frequently in the supraspinatus tendon of the rotator cuff. 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 acute or chronic, with acute cases often presenting with sudden onset of severe pain.

Symptoms

Patients with calcific tendinitis typically experience:
- Severe shoulder pain: This pain may be localized to the shoulder and can radiate down the arm.
- Limited range of motion: Patients often have difficulty lifting their arm or performing overhead activities.
- Swelling and tenderness: The affected area may be swollen and tender to touch.
- Night pain: Many patients report increased pain at night, which can disrupt sleep.

Diagnosis

Diagnosis of calcific tendinitis is primarily clinical, supported by imaging studies. Key diagnostic steps include:
- Physical examination: Assessment of pain, range of motion, and tenderness in the shoulder.
- Imaging: X-rays are commonly used to visualize calcifications in the tendon. Ultrasound and MRI may also be employed to assess the extent of the condition and rule out other shoulder pathologies.

Treatment Options

Conservative Management

Initial treatment typically involves conservative measures, including:
- Rest and activity modification: Avoiding activities that exacerbate pain.
- Physical therapy: Exercises to improve range of motion and strengthen shoulder muscles.
- Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) can help reduce pain and inflammation.

Interventional Procedures

If conservative treatment fails, more invasive options may be considered:
- Corticosteroid injections: These can provide temporary relief from inflammation and pain.
- Extracorporeal shock wave therapy: This non-invasive treatment can help break down calcium deposits.
- Surgical intervention: In cases where symptoms persist despite other treatments, arthroscopic surgery may be performed to remove the calcific deposits.

Prognosis

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

Conclusion

ICD-10 code M75.31 encapsulates a common yet impactful condition affecting the shoulder, characterized by calcium deposits in the tendons. Understanding the clinical presentation, diagnostic approach, and treatment options is essential for effective management and improved patient outcomes. Early intervention and a tailored treatment plan can significantly enhance recovery and restore shoulder function.

Calcific tendinitis of the right shoulder, classified under ICD-10 code M75.31, 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 the clinical presentation, signs, symptoms, and patient characteristics associated with this condition.

Clinical Presentation

Symptoms

Patients with calcific tendinitis typically present with the following symptoms:

• Shoulder Pain: The most prominent symptom is localized pain in the shoulder, which may be sharp or aching. The pain often worsens with overhead activities or lifting objects.
• Limited Range of Motion: Patients may experience a reduced range of motion in the shoulder, particularly in abduction and external rotation. This limitation can be due to pain or mechanical blockage from the calcific deposits.
• Night Pain: Many patients report increased pain at night, which can disrupt sleep and lead to further discomfort.
• Weakness: There may be associated weakness in the shoulder, particularly when performing activities that require lifting or reaching.

Signs

On physical examination, the following signs may be observed:

• Tenderness: Palpation of the shoulder may reveal tenderness over the greater tuberosity and the area of the rotator cuff.
• Positive Impingement Signs: Tests such as the Neer and Hawkins-Kennedy tests may elicit pain, indicating impingement of the rotator cuff tendons.
• Decreased Range of Motion: Active and passive range of motion may be limited, particularly in abduction and external rotation.
• Crepitus: Some patients may experience a sensation of crepitus (a grating sound or sensation) during shoulder movement.

Patient Characteristics

Demographics

• Age: Calcific tendinitis is more common in individuals aged 30 to 60 years, with a peak incidence in those around 40 to 50 years old.
• Gender: There is a slight female predominance, although it can affect both genders.

Risk Factors

Several factors may predispose individuals to develop calcific tendinitis, including:

• Occupational Activities: Jobs that require repetitive overhead movements or heavy lifting can increase the risk of developing this condition.
• Previous Shoulder Injuries: A history of shoulder trauma or previous rotator cuff injuries may contribute to the development of calcific deposits.
• Metabolic Disorders: Conditions such as diabetes or thyroid disorders may be associated with an increased risk of calcific tendinitis.

Comorbidities

Patients may also present with other musculoskeletal conditions, such as:

• Rotator Cuff Tears: There is a potential association between calcific tendinitis and rotator cuff tears, which can complicate the clinical picture.
• Shoulder Osteoarthritis: Degenerative changes in the shoulder joint may coexist with calcific tendinitis, particularly in older adults.

Conclusion

Calcific tendinitis of the right shoulder (ICD-10 code M75.31) is characterized by significant shoulder pain, limited range of motion, and tenderness, particularly in individuals aged 30 to 60 years. Understanding the clinical presentation, signs, symptoms, and patient characteristics is crucial for accurate diagnosis and effective management. Treatment options may include conservative measures such as physical therapy, corticosteroid injections, and, in some cases, surgical intervention if conservative management fails. Early recognition and appropriate treatment can help alleviate symptoms and restore function in affected individuals.

Calcific tendinitis of the right shoulder, designated by the ICD-10 code M75.31, is a specific condition characterized by the accumulation of calcium deposits in the tendons of the shoulder, leading to pain and restricted movement. Understanding alternative names and related terms can enhance clarity in medical documentation and communication. Below are some alternative names and related terms associated with this condition.

Alternative Names

1. Calcific Tendonitis: This is a more general term that refers to the inflammation of a tendon due to calcium deposits, applicable to various locations in the body, including the shoulder.

2. Shoulder Calcific Tendinitis: This term specifies the location of the condition, emphasizing that it occurs in the shoulder region.

3. Calcific Tendinopathy: This term is often used interchangeably with calcific tendonitis, highlighting the degenerative aspect of the tendon condition.

4. Subacromial Calcific Tendinitis: This name refers to the specific area of the shoulder where the calcium deposits may occur, particularly under the acromion.

5. Shoulder Impingement Syndrome: While not synonymous, calcific tendinitis can contribute to shoulder impingement, where the rotator cuff tendons are compressed during shoulder movements.

Related Terms

1. Rotator Cuff Disorders: Calcific tendinitis is often categorized under broader rotator cuff disorders, which include various conditions affecting the rotator cuff tendons.

2. Tendinopathy: A general term for tendon injuries that can include inflammation, degeneration, or calcification.

3. Shoulder Pain: A common symptom associated with calcific tendinitis, which can also relate to other shoulder conditions.

4. Bursitis: Inflammation of the bursa, which can occur alongside calcific tendinitis, leading to similar symptoms.

5. Impingement Syndrome: A condition that may arise due to the presence of calcific deposits, causing pain and limited range of motion.

6. Tendon Calcification: A broader term that describes the process of calcium buildup in tendons, applicable to various anatomical locations.

Conclusion

Understanding the alternative names and related terms for ICD-10 code M75.31 is essential for accurate diagnosis, treatment, and communication among healthcare professionals. These terms not only facilitate better understanding of the condition but also aid in the documentation and coding processes in medical settings. If you have further questions or need additional information on this topic, feel free to ask!

Calcific tendinitis of the right shoulder, classified under ICD-10 code M75.31, is a condition characterized by the deposition of calcium salts in the rotator cuff tendons, leading to pain and restricted movement. The diagnosis of this condition typically involves a combination of clinical evaluation and imaging studies. Below are the key criteria used for diagnosis:

Clinical Evaluation

1. Patient History

• Symptoms: Patients often report shoulder pain, which may be acute or chronic. The pain is usually localized to the shoulder and can radiate down the arm. Patients may also experience stiffness and limited range of motion.
• Duration: The duration of symptoms can help differentiate calcific tendinitis from other shoulder conditions. Symptoms lasting several weeks to months may suggest calcific tendinitis.

2. Physical Examination

• Tenderness: Palpation of the shoulder may reveal tenderness over the greater tuberosity of the humerus, where the rotator cuff tendons attach.
• Range of Motion: Assessment of active and passive range of motion is crucial. Patients may exhibit a decreased range of motion, particularly in abduction and external rotation.
• Special Tests: Specific tests, such as the Neer test or Hawkins-Kennedy test, may be performed to assess for impingement and pain associated with shoulder movement.

Imaging Studies

1. X-rays

• Calcific Deposits: X-rays are the first-line imaging modality and can reveal calcific deposits in the rotator cuff tendons. The presence of these deposits is a key indicator of calcific tendinitis.
• Exclusion of Other Conditions: X-rays also help rule out other potential causes of shoulder pain, such as fractures or arthritis.

2. Ultrasound

• Dynamic Assessment: Ultrasound can provide real-time imaging of the shoulder, allowing for dynamic assessment of the rotator cuff and visualization of calcific deposits.
• Soft Tissue Evaluation: It can also help evaluate the surrounding soft tissues and assess for any associated inflammation or tears.

3. MRI

• Detailed Imaging: While not always necessary, MRI can be used for a more detailed evaluation of the rotator cuff tendons and surrounding structures. It can help identify associated conditions, such as rotator cuff tears or bursitis.

Diagnostic Criteria Summary

To diagnose calcific tendinitis of the right shoulder (ICD-10 code M75.31), healthcare providers typically consider:
- A combination of patient history and physical examination findings.
- The presence of calcific deposits on X-ray imaging.
- Additional imaging studies (ultrasound or MRI) as needed to confirm the diagnosis and rule out other conditions.

In summary, the diagnosis of calcific tendinitis involves a thorough clinical assessment complemented by appropriate imaging studies to confirm the presence of calcific deposits and evaluate the extent of the condition. This comprehensive approach ensures accurate diagnosis and effective management of the condition.

Calcific tendinitis of the right shoulder, classified under ICD-10 code M75.31, is a condition characterized by the accumulation of calcium deposits in the rotator cuff tendons, leading to pain and restricted mobility. The management of this condition typically involves a combination of conservative and, in some cases, more invasive treatment strategies. Below is a detailed overview of standard treatment approaches for this condition.

Conservative Treatment Options

1. Physical Therapy

Physical therapy is often the first line of treatment for calcific tendinitis. It focuses on:
- Pain Relief: Techniques such as ultrasound therapy, electrical stimulation, and manual therapy can help alleviate pain.
- Strengthening Exercises: Gradual strengthening of the shoulder muscles can improve stability and function.
- Range of Motion Exercises: Stretching and mobility exercises are crucial to restore normal movement and prevent stiffness.

2. Medications

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

3. Activity Modification

Patients are advised to avoid activities that exacerbate shoulder pain. Modifying daily activities and ergonomics can help reduce strain on the shoulder.

4. Extracorporeal Shock Wave Therapy (ESWT)

This non-invasive treatment uses sound waves to promote healing in the affected area. Studies have shown that ESWT can be effective in reducing pain and improving function in patients with calcific tendinitis[1].

Invasive Treatment Options

1. Needle Aspiration

In cases where conservative treatments fail, needle aspiration may be performed. This procedure involves using a needle to remove calcium deposits from the shoulder, which can provide immediate pain relief.

2. Surgery

Surgical intervention is considered when:
- Symptoms persist despite extensive conservative treatment.
- There is significant impairment in shoulder function.
- The calcium deposits are large or causing severe pain.

The surgical options include:
- Arthroscopic Surgery: This minimally invasive procedure allows for the removal of calcium deposits and any damaged tissue.
- Open Surgery: In more complex cases, open surgery may be necessary to access and treat the affected area.

Post-Treatment Rehabilitation

Regardless of the treatment approach, rehabilitation is essential for recovery. A structured rehabilitation program typically includes:
- Continued Physical Therapy: To regain strength and mobility.
- Gradual Return to Activities: Patients are guided on how to safely resume normal activities and sports.

Conclusion

The management of calcific tendinitis of the right shoulder (ICD-10 code M75.31) primarily involves conservative treatments such as physical therapy, medications, and activity modification. In cases where these methods are ineffective, more invasive options like needle aspiration or surgery may be considered. A comprehensive rehabilitation program is crucial for optimal recovery and return to function. As always, treatment should be tailored to the individual patient based on the severity of symptoms and response to initial therapies.

[1] Extracorporeal Shock-Wave Therapy for Musculoskeletal Conditions.