Characteristics of dynamic magnetic resonance imaging of symptomatic chronic calcifying tendinitis: preliminary case reports

BACKGROUND: The symptoms of chronic calcifying tendinitis consist of shoulder contracture and impingement sign. However, there have been no reports about the use of imaging studies to differentiate these 2 clinical symptoms. A “burning sign” caused by abnormal blood flow was previously reported in the shoulder joint in patients with frozen shoulder by dynamic magnetic resonance imaging. This burning sign was related to pain. The purpose of this study was to investigate the dynamic magnetic resonance imaging findings in patients with symptomatic chronic calcifying tendinitis and to examine the relationship between the location of the burning sign and the physical findings. METHODS: We retrospectively analyzed data for 6 patients with symptomatic chronic calcifying tendinitis (mean age, 55.5 ± 9.3 years; 4 women). The range of shoulder motion, impingement sign, and location of the burning sign were assessed. RESULTS: Four patients had an impingement sign without shoulder contracture, and the other 2 patients had shoulder contracture. All the patients with an impingement sign also had a burning sign around the calcium deposit and no enhancement in the rotator interval and axillary pouch. Conversely, all the patients with contracture had a burning sign in the rotator interval and axillary pouch and no enhancement around the calcium deposit. CONCLUSIONS: Dynamic magnetic resonance imaging identified 2 types of findings in patients with symptomatic chronic calcifying tendinitis: a burning sign in the rotator interval and axillary pouch or around the calcium deposit. The former pattern may be related to shoulder contracture, whereas the latter may be related to impingement sign.