Treatment of Calcific Tendonitis of the Rotator Cuff: An Updated Review.

This article provides a comprehensive review of rotator cuff calcific tendonitis (RCCT), a painful condition characterized by calcium deposits in the rotator cuff tendons, most commonly the supraspinatus tendon. It discusses the pathophysiology, diagnostic imaging, and a range of treatment options, emphasizing that nonoperative management—including nonsteroidal anti-inflammatory drugs (NSAIDs), physical therapy, and corticosteroid injections—is preferred initially due to high success rates and the potential for spontaneous resolution. When conservative treatments fail after six months, second-line therapies such as extracorporeal shockwave therapy (ESWT) and ultrasound-guided needling (UGN) are considered, with evidence suggesting UGN may lead to better outcomes and fewer additional treatments. Surgical intervention is reserved for refractory cases, with current literature supporting partial removal of calcium deposits to preserve rotator cuff integrity, and indicating that subacromial decompression may not provide added long-term benefit, while rotator cuff repair after debridement can improve patient outcomes when necessary.