Division of Musculoskeletal Radiology, Department of Radiology, Henry Ford Hospital, Detroit, MI, USA.
Clin Rheumatol. 2021 Jul;40(7):2897-2905. doi: 10.1007/s10067-021-05597-8. Epub 2021 Jan 21.
To compare the incidence of rotator cuff (RC) tears on shoulder ultrasounds of patients with RC calcific tendinopathy (CaT) to that of a control group without CaT.
In this retrospective case-control study, 50 shoulder ultrasounds of patients with CaT were compared independently by 2 musculoskeletal radiologists to 50 patients from a control group without CaT to catalog the number and type of RC tears. RC tears in the CaT group were further characterized based on location, into tears in the specific tendon(s) containing calcium versus all tendon tears.
RC tears were diagnosed in 38% (19/50) of the control group (16 full-thickness) as compared to 22% (11/50) with CaT (6 full-thickness). The fewer full-thickness tears in the CaT group (12%, 6 of 50) compared to that in the control group (32%, 16 of 50) was statistically significant (P = 0.016, odds ratio 0.29). Only 7 of the 11 tears in the CaT group were in a calcium-containing tendon (3 full-thickness). The fewer calcium-containing tendon tears compared to tears in the control group was also statistically significant (P = 0.006, odds ratio 0.27). Furthermore, the fewer full-thickness calcium-containing tendon tears (6%, 3/50) compared to full-thickness tears in the control group (32%, 16/50) were yet more statistically significant (P = 0.001, odds ratio 0.14).
In patients with shoulder pain and CaT, we observed a decreased number of RC tears and especially calcium-containing tendon tears, as compared to similar demographic patients with shoulder pain but without CaT. Key Points • Patients with rotator cuff calcific tendinopathy have few rotator cuff tears, especially full-thickness tears, compared to a control group without calcific tendinopathy. • The tendons containing the calcium hydroxyapatite deposition were the least likely to have a rotator cuff tear. • Future studies could evaluate if calcium hydroxyapatite deposition provides a protective mechanism against rotator cuff tears. • Musculoskeletal ultrasound is more sensitive than MRI in the evaluation of rotator cuff calcific tendinopathy.
比较肩袖（RC）钙化性肌腱炎（CaT）患者的 RC 撕裂超声与无 CaT 的对照组患者的 RC 撕裂发生率。
在这项回顾性病例对照研究中，由 2 名肌肉骨骼放射科医生独立比较了 50 例 CaT 患者的 50 例肩超声与无 CaT 的对照组患者的肩超声，以记录 RC 撕裂的数量和类型。根据位置，将 CaT 组中的 RC 撕裂进一步分为含有钙的特定肌腱（s）撕裂与所有肌腱撕裂。
在对照组（19/50，38%）中诊断出 RC 撕裂，而在 CaT 组（11/50，22%）中诊断出 RC 撕裂。CaT 组中全层撕裂较少（12%，50 例中有 6 例），而对照组中全层撕裂较多（32%，50 例中有 16 例），差异有统计学意义（P=0.016，优势比 0.29）。CaT 组的 11 个撕裂中只有 7 个位于含钙肌腱中（3 个全层）。与对照组相比，含钙肌腱撕裂较少，差异有统计学意义（P=0.006，优势比 0.27）。此外，与对照组相比，全层含钙肌腱撕裂（6%，50 例中有 3 例）更少，差异更有统计学意义（P=0.001，优势比 0.14）。
与患有肩痛但无 CaT 的类似人群相比，患有肩痛和 CaT 的患者 RC 撕裂的数量较少，尤其是含钙肌腱撕裂。关键要点•与无钙化性肌腱炎的对照组相比，肩袖钙化性肌腱病患者的肩袖撕裂，尤其是全层撕裂较少。•含有钙羟磷灰石沉积的肌腱最不可能发生肩袖撕裂。•未来的研究可以评估钙羟磷灰石沉积是否提供了对肩袖撕裂的保护机制。•肌肉骨骼超声在评估肩袖钙化性肌腱病方面比 MRI 更敏感。
