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M75.3 Calcific Tendinitis – Causes, Symptoms & Treatment
M75.3 is the ICD-10 code for calcific tendinitis of the shoulder: calcium deposits in shoulder tendons cause pain and restricted movement.
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M75.3 is the ICD-10 code for calcific tendinitis of the shoulder: calcium deposits in shoulder tendons cause pain and restricted movement.
What is M75.3 – Calcific Tendinitis of the Shoulder?
The ICD-10 code M75.3 refers to calcific tendinitis of the shoulder, also known as calcareous tendinitis or calcium deposit tendinitis. This condition involves the accumulation of calcium crystals within the tendons of the shoulder, most commonly in the supraspinatus tendon of the rotator cuff. These deposits can cause significant pain and limit the range of motion of the shoulder joint.
Causes
The exact cause of calcific tendinitis is not fully understood. Several contributing factors have been identified:
- Reduced blood supply to the tendon: Areas with poor vascularisation are more prone to calcium accumulation.
- Degenerative changes: Wear and tear due to overuse or aging can predispose tendons to calcification.
- Metabolic disorders: Hormonal or metabolic conditions may play a role in some patients.
- Repetitive overuse: Repeated overhead movements or sports activities may increase the risk.
Symptoms
Symptoms vary depending on the phase of the condition:
- Acute phase: Sudden onset of severe shoulder pain, often worse at night; significant restriction of movement.
- Chronic phase: Persistent dull aching, tenderness on palpation, and limited shoulder mobility.
- Pain when raising the arm, which may overlap with impingement syndrome.
- Pain may radiate down into the upper arm.
Diagnosis
Diagnosis is based on clinical examination and imaging:
- X-ray of the shoulder: Often sufficient to identify calcium deposits clearly.
- Ultrasound (sonography): Allows precise localisation and assessment of the size of deposits.
- MRI (Magnetic Resonance Imaging): Used in unclear cases or to assess associated rotator cuff damage.
- Clinical tests such as the Painful Arc Test and shoulder palpation complement imaging findings.
Treatment
Conservative Treatment
Most cases respond well to conservative management:
- Physiotherapy: Exercises to strengthen and mobilise the shoulder muscles.
- Pain management: Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or diclofenac for pain relief.
- Corticosteroid injections: Local injections can rapidly reduce acute inflammatory pain.
- Extracorporeal Shock Wave Therapy (ESWT): High-energy sound waves break up calcium deposits; well-supported by clinical evidence.
- Ultrasound-guided lavage (needling): The calcium deposit is dissolved and aspirated using a saline solution under ultrasound guidance.
Surgical Treatment
If conservative measures fail after several months, arthroscopic removal of the calcium deposit may be considered. This minimally invasive procedure yields very good outcomes in most patients.
Prognosis
Calcific tendinitis of the shoulder is often a self-limiting condition. In many patients, calcium deposits dissolve spontaneously over months to years. With appropriate treatment, the majority of patients achieve complete resolution of symptoms. Only a small proportion require surgical intervention.
References
- Deutsche Gesellschaft für Orthopädie und Orthopädische Chirurgie (DGOOC): Guidelines on Shoulder Conditions, 2022.
- Rockwood, C.A. & Matsen, F.A. (eds.): The Shoulder, 5th edition. Elsevier Saunders, 2016.
- Gaujoux-Viala, C. et al.: Efficacy and safety of steroid injections for shoulder and elbow tendonitis. Annals of the Rheumatic Diseases, 2011; 70(10): 1718–1727.
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