Inflammation of the thin-walled bursal sac surrounding tendons and muscles over bony prominences. The subacromial and greater trochanteric bursae are most commonly involved.
Prevention of aggravating conditions, rest, NSAIDs, and local glucocorticoid injections.
May involve virtually any tendon but frequently affects tendons of the rotator cuff around shoulder, especially the supraspinatus. Pain is dull and aching but becomes acute and sharp when tendon is squeezed below acromion.
NSAIDs, glucocorticoid injection, and physical therapy may be beneficial. The rotator cuff tendons or biceps tendon may rupture acutely, frequently requiring surgical repair.
Results from deposition of calcium salts (primarily hydroxyapatite) in tendon, usually supraspinatus. The resulting pain may be sudden and severe.
TREATMENT: CALCIFIC TENDINITIS
Most are self-limited and respond to physical therapy, NSAIDs. Refractory disease treated with ultrasound-guided needle aspiration and lavage or surgery.
ADHESIVE CAPSULITIS ("FROZEN SHOULDER")
Results from conditions that enforce prolonged immobility of shoulder joint. Shoulder is painful and tender to palpation, and both active and passive range of motion is restricted.
TREATMENT: ADHESIVE CAPSULITIS
Spontaneous improvement may occur; physical therapy is the foundation; NSAIDs, local injections of glucocorticoids may be helpful.
For a more detailed discussion, see Taurog JD, Carter JD: The Spondyloarthritides, Chap. 384, p. 2169; Crofford LJ: Fibromyalgia, Chap. 396, p. 2238; Langford CA, Mandell BF: Arthritis Associated with Systemic Disease, and Other Arthritides, Chap. 397, p. 2240; Langford CA: Periarticular Disorders of the Extremities, Chap. 398, p. 2247; Langford CA: Relapsing Polychondritis, Chap. 389, p. 2202, in HPIM-19.