Humeral greater tuberosity osteolysis as a complication of intraosseous calcification migration: natural history depicted by imaging

Humeral greater tuberosity osteolysis as a complication of intraosseous calcification migration: natural history depicted by imaging

Authors

  • Virna Zampa Department of Interventional and Diagnostic Radiology Azienda Ospedaliero-Universitaria Pisana
  • Giacomo Aringhieri Department of Interventional and Diagnostic Radiology Azienda Ospedaliero-Universitaria Pisana
  • Piercarlo Rossi Department of Interventional and Diagnostic Radiology Azienda Ospedaliero-Universitaria Pisana
  • Rodolfo Capanna Department of Orthopedic Surgery Azienda Ospedaliero-Universitaria Pisana
  • Davide Caramella Department of Interventional and Diagnostic Radiology Azienda Ospedaliero-Universitaria Pisana

Keywords:

Complication of calcific tendinitis; humeral osteolysis; MRI; CT

Abstract

Migration of calcification within the bone leading to greater tuberosity osteolysis is a peculiar complication of the calcifying tendinitis of the rotator cuff. The case of a 38-year-old woman complaining of right shoulder pain, which had been going on for one year, is hereby described. The evolution of the infraspinatus tendon calcifying tendinitis leading to osteolysis of the greater tuberosity of the humerus is depicted by imaging and, particularly, by the MR and CT features changing over time. In this paper we focus on the importance of both MR and CT exams in the diagnostic process of the different phases of the disease. The correlation between clinical symptoms and imaging features is also helpful for imaging interpretation: the most painful phase corresponds to the migration of the calcification, whereas pain tends to decrease when the osteolysis develops. Awareness of the existence of this condition may prevent unnecessary invasive procedures.

References

Merolla G, Bhat MG, Paladini P, Porcellini G; Complications of calcific tendinitis of the shoulder: a concise review. J Orthop Traumatol. 2015 Sep; 16(3): 175–183.

Porcellini G, Paladini P, Campi F, Pegreffi F; Osteolytic lesion of greater tuberosity in calcific tendinitis of the shoulder. J Shoulder Elbow Surg. 2009 Mar-Apr;18(2):210-5. doi: 10.1016/j.jse.2008.09.016.

Flemming DJ, Murphey MD, Shekitka KM, Temple HT, Jelinek JJ, Kransdorf MJ. Osseous involvement in calcific tendinitis: a retrospective review of 50 cases.AJR Am J Roentgenol. 2003 Oct;181(4):965-72.

Chan R, Kim DH, Millett PJ, Weissman BN.Calcifying tendinitis of the rotator cuff with cortical bone erosion. Skeletal Radiol. 2004 Oct;33(10):596-9.

Martin S, Rapariz JM. Intraosseous calcium migration in calcifying tendinitis: a rare cause of single sclerotic injury in the humeral head (2010: 2b). Eur Radiol. 2010 May;20(5):1284-6. doi: 10.1007/s00330-009-1500-9.

Malghem J, Omoumi P, Lecouvet F, Vande Berg B. Intraosseous migration of tendinous calcifications: cortical erosions, subcortical migration and extensive intramedullary diffusion, a SIMS series.Skeletal Radiol (2015) 44:1403–1412. DOI 10.1007/s00256-015-2165-x

Marinetti A, Sessa M, Falzone A, Della Sala SW. Intraosseous migration of tendinous calcifications: two case reports.Skeletal Radiol. 2018 Jan;47(1):131-136. doi: 10.1007/s00256-017-2769-4.

Pereira BP, Chang EY, Resnick DL, Pathria MN.Intramuscular migration of calcium hydroxyapatite crystal deposits involving the rotator cuff tendons of the shoulder: report of 11 patients. Skeletal Radiol. 2016 Jan;45(1):97-103. doi: 10.1007/s00256-015-2255-9.

Chai JW, Houng SH, Choi JY, Koh YH, Lee JW, Choi Ja, Kang HS. Radiologic Diagnosis of Osteoid Osteoma: from simple to challenging findings. Radiographics. 2010 May;30(3):737-49. doi: 10.1148/rg.303095120.

Zampa V, Bargellini I, Ortori S, Faggioni L, Cioni R, Bartolozzi C. Osteoid osteoma in atypical locations: the added value of dynamic gadolinium-enhanced MR imaging. Eur J Radiol. 2009 Sep;71(3):527-35. doi: 10.1016/j.ejrad.2008.05.010.

Kraemer EJ, El-Khoury GY. Atypical calcific tendinitis with cortical erosions. Skeletal Radiol. 2000 Dec;29(12):690-6.

Sola WC Jr, Drake GN, Ramos CH, Gomes A, Gartsman GM. Calcific tendinitis of the rotator cuff associated with intraosseous loculation: two case reports. J Shoulder Elbow Surg. 2009 Nov-Dec;18(6):e6-8. doi: 10.1016/j.jse.2009.02.009.

Downloads

Published

30-04-2021

How to Cite

1.
Zampa V, Aringhieri G, Rossi P, Capanna R, Caramella D. Humeral greater tuberosity osteolysis as a complication of intraosseous calcification migration: natural history depicted by imaging. Acta Biomed [Internet]. 2021 Apr. 30 [cited 2024 Jul. 20];92(S1):e2021052. Available from: https://www.mattioli1885journals.com/index.php/actabiomedica/article/view/8370