How is chronic calcific tendinitis treated?
Asymptomatic BCP deposits at periarticular sites require no therapy. Patients with symptomatic chronic calcific tendinitis (or bursitis) are managed conservatively, with physical therapy and nonsteroidal antiinflammatory drugs (NSAIDs). Local injection with a short-acting corticosteroid should be used sparingly because steroids may promote calcification in the long term. Barbotage refers to the use of a needle for repetitive aspiration and lavage to disrupt the local calcification, which may promote more rapid dissolution of the deposit by stimulating phagocytosis of the BCP crystals. Other therapies that have been described include treatment with EDTA and high-energy extracorporeal shockwave therapy. Surgical or arthroscopic debridement of very large or severely symptomatic calcific deposits may be necessary. Pulsed ultrasound therapy has shown recent promise for dissolving BCP crystals.
