Correlations among mineral components, progressive calcification process and clinical symptoms of calcific tendonitis.
OBJECTIVE
To establish the correlations among the mineral components, progressive calcification process and clinical symptoms of calcific tendonitis.


METHODS
The morphology of the calcified deposits on the shoulders of 28 patients with calcific tendonitis was determined by high-resolution ultrasonography. The calcified deposit from each patient was aspirated and determined by the Fourier transform infrared and Raman microspectroscopies. The curve-fitting program was applied to estimate the chemical component in the calcified deposits of calcific tendonitis.


RESULTS
The morphology of calcified deposits for 28 patients was classified into four shapes: arc shape (7 patients), fragmented/punctuate shape (4 patients), nodular shape (13 patients) and cystic shape (4 patients). These classified shapes markedly correlated with the pain levels in patients. The infrared spectra of all the calcified deposits for 28 patients were easily classified into three types in the blind study and corresponded to the formative, resting and resorptive phases in the progressive calcification process of calcific tendonitis. With the progressive calcification, the IR wavenumber at 1018 cm(-1) assigned to poorly crystalline, non-stoichiometric apatite for the formative phase was shifted to 1028 cm(-1) for the resting phase and then to 1031 cm(-1) due to matured crystalline stoichiometric apatite for the resorptive phase. The curve-fitted results revealed that calcified deposits in calcific tendonitis were composed of different quantities of A-type and B-type carbonated apatites in the three phases. A significant difference was found in carbonated apatite content among the three phases (P < 0.001).


CONCLUSIONS
The different quantities of A-type and B-type carbonated apatites determined by vibrational microspectroscopy in calcified deposits were well correlated with those of the four shapes of morphologic classification, with the three phases in the progressive calcification process and with the clinical symptoms of calcific tendonitis.
Chiou
Hong-Jen
HJ
Department of Biotechnology, Yuanpei University, Taiwan, Republic of China.
Hung
Shih-Chieh
SC
Lin
Shan-Yang
SY
Wei
Yen-Shan
YS
Li
Mei-Jane
MJ
D000368:Aged; D000369:Aged, 80 and over; D001031:Apatites / Q000032:analysis; D002114:Calcinosis / Q000000981:diagnostic imaging / Q000378:metabolism* / Q000473:pathology; D003460:Crystallization; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008903:Minerals / Q000032:analysis*; D012785:Shoulder Joint / Q000000981:diagnostic imaging / Q000378:metabolism* / Q000473:pathology; D020069:Shoulder Pain / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology; D017550:Spectroscopy, Fourier Transform Infrared; D013059:Spectrum Analysis, Raman / Q000379:methods; D052256:Tendinopathy / Q000000981:diagnostic imaging / Q000378:metabolism* / Q000473:pathology; D014463:Ultrasonography
D001031:Apatites; D008903:Minerals