Arthroscopic treatment of a rare giant calcific tendinitis of the supraspinatus:a case report

LIU Chen; YUAN Ling-wei; WU Jin-qiu; TANG Zhao-peng; MA Tao; HAN Xian-fu; LIU Xue-rui; YANG Guo-qing; HE Hai-rong; SUN Ru

doi:10.3969/j.issn.2095-252X.2025.11.012

Abstract：Calcific tendinitis is one of the common causes of shoulder pain, typically involving the rotator cuff, particularly the supraspinatus tendon. Most cases present with small calcific deposits (in the resorptive phase) and can be managed conservatively with nonsteroidal anti-inflammatory drugs, physical therapy, or ultrasound-guided needle lavage. However, giant calcific deposits (diameter > 3 cm) are rare and often refractory to conservative treatment, usually requiring surgical intervention. This article reports the diagnosis and treatment of a case of giant calcific tendinitis and discusses the technical considerations and clinical outcomes of arthroscopic surgery. The patient was a 60-year-old woman presenting with 'right shoulder pain and limited mobility for 5 years, aggravated in the past week.' Previous symptomatic treatments, including topical analgesics and oral painkillers (specific names and dosages unknown), provided no significant relief. Physical examination revealed markedly restricted internal rotation and positive Neer and Hawkins signs. Imaging studies showed a high-density calcific deposit (approximately 3 cm in diameter) along the supraspinatus tendon on X-ray, with significant perilesional edema and subacromial impingement on MRI. Given the large lesion size and prolonged symptoms, arthroscopic calcific deposit removal was performed. Using a standard posterior portal, toothpaste-like calcific material was visualized and completely debrided, followed by subacromial decompression to address impingement and tendon repair. Postoperatively, the patient experienced significant pain relief, and follow-up MRI at 5 weeks showed no recurrence. This case suggests that for rare, giant calcific tendinitis unresponsive to conservative treatment, arthroscopic surgery (with its magnified visualization) allows precise lesion removal while minimizing tissue damage and addressing concurrent impingement. Its advantages, including minimal invasiveness, direct visualization, and rapid recovery, make it the preferred treatment for such complex cases.