Williams Ariel A, Stang Thomas S, Fritz Jan, Papp Derek F
Orthopedics. 2016 Sep 1;39(5):e997-e1000. doi: 10.3928/01477447-20160616-08. Epub 2016 Jun 24.
Calcific tendinitis is a relatively rare condition in which calcium is inappropriately deposited in tendons, resulting in a local inflammatory reaction that can cause severe symptoms in certain cases. The cause of this disease process is not completely understood, although repetitive microtrauma likely plays a role in its development. Although the disorder most often involves the rotator cuff, it can affect other structures throughout the body, such as the tendons about the ankle and hip-including the rectus femoris and gluteus maximus. Nonoperative management typically involves using an anti-inflammatory medication and activity modification and can be augmented with formal physical therapy and modalities. Although nonoperative management provides adequate relief for many patients, sometimes operative debridement of the calcific deposit with or without repair of the involved tendon is required. The authors report an unusual case of calcific tendinitis of the gluteus maximus insertion in a golfer. The patient had tried nonoperative treatment for approximately 2 years with no real relief, and a recent exacerbation of the pain was significantly delaying his return to sport. Although plain radiographs did not show abnormalities, magnetic resonance imaging showed a calcific deposit in the insertion of the gluteus maximus tendon. After discussing further treatment options with the patient, the decision was made to remove the deposit and repair the insertion. He recovered completely and was able to return to play. The frequency, pathogenesis, and treatment of this condition are discussed in this case report, as well as the possible link to golf in this patient. [Orthopedics.2016; 39(5):e997-e1000.].
钙化性肌腱炎是一种相对罕见的病症,钙质在肌腱中异常沉积,导致局部炎症反应,在某些情况下可引起严重症状。尽管重复的微创伤可能在其发展过程中起作用,但这种疾病过程的病因尚未完全明确。虽然该病症最常累及肩袖,但也可影响全身其他结构,如踝关节和髋关节周围的肌腱,包括股直肌和臀大肌。非手术治疗通常包括使用抗炎药物和调整活动,可辅以正规的物理治疗和方法。虽然非手术治疗能为许多患者提供足够的缓解,但有时需要对钙化沉积物进行手术清创,可伴有或不伴有对受累肌腱的修复。作者报告了一例高尔夫球手臀大肌附着处钙化性肌腱炎的罕见病例。患者尝试非手术治疗约2年,未获真正缓解,近期疼痛加重显著延迟了他重返运动的时间。虽然X线平片未显示异常,但磁共振成像显示臀大肌肌腱附着处有钙化沉积物。在与患者讨论进一步的治疗方案后,决定取出沉积物并修复附着处。他完全康复并能够重返赛场。本病例报告讨论了这种病症的发生率、发病机制和治疗方法,以及该患者与高尔夫运动可能存在的联系。[《骨科》.2016; 39(5):e997-e1000.]