The bursitis in combination with a calcified shoulder | Bursitis of the shoulder

The bursitis in combination with a calcified shoulder

The calcified shoulder represents an independent clinical picture, which is however frequently associated with the bursitis of the shoulder. Both diseases can be caused by overstrain, accidents, pressure and tension, but also metabolic and circulatory disorders. The development of the calcified shoulder begins with the transformation of tendons of the shoulder into cartilage tissue due to the reduced blood circulation.

Lime is then deposited in these structures. These calcium deposits are often located in the area below the acromion, where they can in turn press on the bursa. This in turn can cause bursitis. The remaining shoulder muscles can also become inflamed and damaged. In most cases, the calcified shoulder does not need to be treated, as the inflammation subsides by itself and the calcification is reduced again.

The diagnosis

The diagnosis is usually based on the clinical symptoms of the painful bow. The diagnosis can also be supported by an x-ray image, but due to the radiation exposure during x-rays, ultrasound can also be used. A further imaging examination here is magnetic resonance imaging of the shoulder (MRI of the shoulder).

In this examination, especially soft tissue swelling and effusions in the shoulder joint can be well visualized. However, MRI of the shoulder is rarely used in cases of bursitis of the shoulder, as the examination takes a relatively long time and the examination of the movement and pain pattern is usually unambiguous. Since effusions can also be detected with the ultrasound device, which is available in many general practitioners’ practices, this is a good alternative to the very complex MRI.

In addition, there are several functional tests that are carried out if bursitis of the shoulder is suspected. During the examination for the so-called Neer sign, the patient is asked to keep the arm stretched out in the starting position while the examiner fixes the shoulder blade. Then the patient is asked to lift the arm, pain when lifting the arm indicates impingement syndrome.

This is called a positive Neer sign. The bursitis is a diagnosis that in most cases results from the symptoms and the physical examination. Other procedures such as MRI are rarely used because they are expensive and time-consuming.

MRI, however, allows changes such as inflammation, soft tissue swelling, effusions and muscle degeneration to be detected very clearly. MRI is particularly suitable for assessing soft tissue. Accordingly, in the case of bursitis, swelling and inflammation of the bursa and surrounding muscles can often be detected.

Effusions of the inflammation in the joint can also often be seen in the MRI. However, these can also be detected in the ultrasound examination, so an MRI examination is not necessary in most cases.More information is available here: MRT of the shoulder joint. The ultrasound examination is often the first step after the patient’s medical history and physical examination, as it is a cheap, simple and quick examination. Similar to the MRI, ultrasound can detect distensions, distinct swellings, centres of inflammation and effusions in the shoulder joint. However, the sharpness of the image allows only limited conclusions about the extent of the disease, but can confirm an existing suspicion.