Comprehensive Review of Calcific Tendinopathy of the Supraspinatus: Pathophysiology, Imaging, Diagnosis, and Advanced Treatment Strategies
Abstract Calcific tendinopathy of the supraspinatus is a common cause of shoulder pain, particularly among middle-aged adults. This article provides a comprehensive review of the pathophysiology, epidemiology, clinical presentation, imaging findings, differential diagnosis, and evidence-based management options. The integration of radiological imaging and updated treatment modalities—including ultrasound-guided procedures, shockwave therapy, and arthroscopic removal—are discussed in the context of current international guidelines. 1. Pathophysiology Calcific tendinopathy (CT) of the supraspinatus is a multifactorial, cell-mediated process characterised by the deposition of calcium hydroxyapatite crystals within the tendon substance. Historically regarded as a degenerative condition, modern research identifies it as an active, cell-regulated process involving tenocytes and fibrocartilaginous metaplasia. The disease progresses through three major stages: Formative Phase: Tenocytes un...