Massive tear of an ossified supraspinatus tendon: a case report and review of the literature

Calcific tendinitis of the rotator cuff is often encountered in daily clinical practice, but cases with rotator cuff tears associated with ossification in the rotator cuff are extremely rare. We experienced a 74-year-old male case with ossification in the rotator cuff associated with extensive tearing. At another hospital he had been diagnosed with calcific rotator cuff tendinitis and treated conservatively, although his symptoms did not improve and tended to worsen gradually. His past medical history was unremarkable. On plain radiography a tumor-like shadow was found in the proximal portion of the musculus supraspinatus. On computed tomography the mass was isointense to the epiphysis, and on magnetic resonance imaging almost isointense to the bone marrow, and was judged to be ossification. Extensive tearing of the rotator cuff was also present. Since pain was severe and the range of motion was markedly restricted Reverse shoulder arthroplasty was performed. The postoperative course was favorable with no recurrence of the ossification or pain. Reports of myositis officans in the rotator cuff, an extremely rare condition, have hitherto been limited to 4 cases, 3 of which had ossification in the musculus supraspinatus. Because such lesions may end up being diagnosed as calcinosis, the fact that ossified lesions may develop within the rotator cuff needs to be kept in mind.