Our expert says:
Your questions are interesting. Recurrence of thoracic outlet syndrome is of course possible. In the case of calcific tendonitis, if there is a significantly-sized calcium deposit in the rotator cuff, the pain in the shoulder can occur and pain down the arm into the hand, resembling a nerve origin can certainly happen with calcific tendonitis. If there is a good suspicion of calcific tendonitis – and this can usually be confirmed when examining the patient by the various clinical tests for thoracic outlet and rotator cuff problems, one could decide on managing the calcium deposit which is usually not a difficult procedure. In our unit, we will treat calcific tendonitis as follows:
1. With a cortisone injection to give initial relief and will also be a good diagnostic test.
2. Needling procedure. Under local anaesthetic the calcium is washed out under ultrasound control in our rooms.
3. Should the above fail, an arthroscopic procedure where the calcium is drained in the tendon is usually very successful.
I advise you to look at our website www.shoulderinstitute.co.za and look at the two conditions, especially calcific tendonitis as well as thoracic outlet syndrome.
I hope that helps you.
DR J DE BEER
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