Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital/Harvard Medical School, Boston, MA, USA.
Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN, USA.
J Osteopath Med. 2022 Feb 4;122(3):141-151. doi: 10.1515/jom-2021-0213.
Calcific tendinopathy (CT) is an important musculoskeletal condition most commonly seen in the shoulder girdle, accounting for 10-42% of all shoulder pain. Despite the high prevalence within the shoulder region, CT has been demonstrated in many tendons throughout the axial and appendicular skeleton. Unlike degenerative tendinopathies, CT appears to be a self-limiting condition that affects otherwise-healthy tendon with deposition of calcium hydroxyapatite crystals between healthy tenocytes. In patients with functionally limiting symptoms or pain, the clinical course may be accelerated through a multitude of treatments including physical therapy and pain management, extracorporeal shock wave therapy, ultrasound-guided percutaneous lavage (UGPL), and operative debridement. Currently, the most efficacious and frequently utilized treatment for shoulder CT is UGPL due to its ability to effectively reduce calcium burden and pain while limiting soft-tissue damage. However, more evidence regarding the treatment and course of CT is needed before determining the most appropriate treatment at all potential sites of CT.
钙化性肌腱病（CT）是一种重要的肌肉骨骼疾病，最常见于肩带，占所有肩部疼痛的 10-42%。尽管在肩部区域的患病率很高，但 CT 已在轴向和附肢骨骼的许多肌腱中得到证实。与退行性肌腱病不同，CT 似乎是一种自限性疾病，会影响原本健康的肌腱，在健康的肌腱细胞之间沉积羟基磷灰石钙晶体。对于有功能受限症状或疼痛的患者，通过多种治疗方法，包括物理治疗和疼痛管理、体外冲击波治疗、超声引导下经皮冲洗（UGPL）和手术清创，可以加速临床病程。目前，由于 UGPL 能够有效减轻钙负荷和疼痛，同时限制软组织损伤，因此是治疗肩部 CT 的最有效和最常用的方法。然而，在确定 CT 所有潜在部位的最佳治疗方法之前，还需要更多关于 CT 的治疗和病程的证据。
