Osteolytic lesion of greater tuberosity in calcific tendinitis of the shoulder

Hypothesis: This study investigated tuberosity osteolysis, an uncommon and frequently misdiagnosed form of calcific tendinitis of the shoulder, and evaluated its effects on clinical and surgical outcomes. Materials and methods: A total of 126 patients with calcific tendinitis studied with radiographs, ultrasound, and magnetic resonance images (MRIs) were divided into groups positive and negative for tuberosity osteolysis and treated by arthroscopy. Follow-up evaluation was at 2 years, using the Constant score. Results: Tuberosity osteolysis was associated with significantly lower Constant scores, both before and after surgical treatment. Clinical and imaging findings exhibited a significant correlation. A 100% correlation was found between arthroscopy and MRI findings of tuberosity osteolysis compared with 90% with radiographs. Conclusion: Imaging and functional data indicate that calcific tendinitis of the rotator cuff with tuberosity osteolysis is a distinctive form of calcific tendinitis that should be considered in clinical and surgical practice. Level of evidence: Level 2; Prospective non-randomized comparison prognosis study. © 2009 Journal of Shoulder and Elbow Surgery Board of Trustees.