Presentation
Ongoing shoulder pain. Attended ED as oral analgesics not controlling pain.
Patient Data
A large focal area of calcification is present superior to the greater tubercle in the subacromial space, most in keeping with rotator cuff calcific tendinopathy. The glenohumeral joint is congruent.
Case Discussion
Calcific tendinopathy or Calcific tendinitis can present acutely with some patients requiring opiates for pain relief. A shoulder radiograph is an appropriate first investigation, even without a history of trauma. Larger areas of calcium hydroxyapatite will be radiopaque, whereas the smaller foci will not always be visible.