[Pathologic glenohumeral stress distribution in calcific tendinosis of the supraspinatus].
OBJECTIVE
Based on hypothesis that calcific tendonitis of the supraspinatus tendon (CTSSP) could be associated with glenohumeral imbalance, glenohumeral stress distribution was analyzed.


METHODS
26 patient shoulders with CTSSP, unsuccessfully treated by non-operative measures, were examined. A group of 26 macroscopically normal shoulder specimens served as controls. Analysis of glenohumeral stress distribution was indirect evaluating glenoid subchondral bone mineralization by computed tomography osteoabsorptiometry. Density distribution of glenoid subchondral bone mineralization and the position of the two most frequent density maxima were analyzed.


RESULTS
Patterns of subchondral mineralization and position of the anterior density maximum were significantly different between both groups. CTSSP mostly presented with a monocentric, anteriorly increased mineralization indicative for a regional increase of stress. The inferior shift of the anterior density maximum demonstrates a parallel shift of glenohumeral stress distribution.


CONCLUSIONS
Mineralization patterns indicate that glenohumeral stress distribution is not physiologic in CTSSP. Moreover, it is comparable with glenohumeral stress distribution as observed in atraumatic antero-inferior glenohumeral instability. Relevance of this observation should be proven for etiology of CTSSP.
Schulz
C U
CU
Orthopädische Klinik, Klinikum Grosshadern, Ludwig-Maximilians-Universität München. christoph.schulz@med.uni-muenchen.de
Maier
M
M
Glaser
C
C
Anetzberger
H
H
Müller-Gerbl
M
M
D002113:Calcification, Physiologic; D002114:Calcinosis / Q000000981:diagnostic imaging / Q000503:physiopathology*; D005260:Female; D006801:Humans; D006811:Humerus / Q000000981:diagnostic imaging / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000379:methods*; D012189:Retrospective Studies; D012785:Shoulder Joint / Q000000981:diagnostic imaging / Q000503:physiopathology*; D013314:Stress, Mechanical; D052256:Tendinopathy / Q000000981:diagnostic imaging / Q000503:physiopathology*