Originally published by 2 Minute Medicine® (view original article). Reused on AccessMedicine with permission.

1. Calcification deposits with a diameter of 6 mm or more in patients younger than 56 years of age were associated with shoulder pain.

2. A distance from calcification to tendon insertion of 6 mm or more in patients 56 years of age and older was associated with pain.

3. A signal on Colour Doppler was associated with shoulder pain.

Evidence Rating Level: 3 (Average)

The shoulder is a common anatomical site for musculoskeletal (MSK) pain. Previous research has shown that calcifications and pain are associated. Calcification size is relevant and shoulders with radiologically-detected calcific deposits >1.5 cm in length are more likely to be symptomatic. Ultrasound (US) is considered to be reliable in the detection and localization of calcifications associated with MSK pain. This case-control study aimed to further investigate US features associated with the presence of shoulder complaints. A total of 140 cases, aged 18-70 years, suffering from shoulder pain and referred for unilateral shoulder US were recruited between February 2018 and June 2020. Controls were invited on a voluntary basis and 62 were randomly selected. Results showed that a calcification size ≥6 mm when age <56 (p = 0.02) and a distance to tendon insertion ≥6 mm when age ≥56 (p = 0.009) were features on US only seen in symptomatic shoulders. Additionally, positive signal on Colour Doppler was more frequent in symptomatic participants (26/140 vs. 2/62, p = 0.003). The US criteria highlighted in this study may aid diagnosis when symptoms and physical examination are ambiguous.

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