ATYPICAL LOCALIZATION OF ROTATOR CUFF CALCIFIC TENDONITIS: VALIDATION OF THE FIVE-STEP SHOULDER ULTRASOUND PROTOCOL IN DETECTION OF SUBSCAPULARIS TENDON CALCIFICATIONS

Calcific tendonitis (CT) is characterized by deposition of calcium phosphate crystals in rotator cuff (RC) tendons of the shoulder. It most commonly involves the supraspinatus tendon even though the subscapularis tendon is a =rare site for calcific deposition, especially in young sportsmen. Herein, we report the case of a 29-year-old professional tennis player with CT of the subscapularis tendon diagnosed by using the European Society of Musculoskeletal Radiology (ESSR) standardized step-by-step shoulder ultrasound (US) protocol and treated with US-guided needling of the calcification site. The aim of this report is to increase the general awareness of the atypical localization of RCCT and to highlight the importance of US imaging in early diagnose and early treatment of this disease. Thus, sports physicians must be aware of the diagnostic and therapeutic possibilities offered by US in order to expedite rapid referral to a musculoskeletal specialist who can perform a point-of-care US examination of the shoulder and, where necessary, an US-guided interventional approach