From the Guidelines
Distal triceps calcific tendinosis should be treated with a combination of relative rest, icing, and eccentric strengthening exercises as the first line of treatment, with surgery reserved for patients who have failed conservative therapy. The condition is characterized by calcium deposits in the triceps tendon near its attachment to the olecranon process of the elbow, causing pain and limited function. According to 1, most patients with overuse tendinopathies, including distal triceps calcific tendinosis, fully recover within three to six months with outpatient treatment. The treatment approach should include:
- Relative rest of the affected area to reduce further injury and allow healing
- Icing to reduce pain and inflammation
- Eccentric strengthening exercises to improve tendon strength and function
- Consideration of topical and systemic nonsteroidal anti-inflammatory drugs for acute pain relief, although these should be used with caution Some key points to consider in the treatment of distal triceps calcific tendinosis include:
- Accurate diagnosis requires recognition of historical features, anatomy, and useful physical examination maneuvers
- Plain radiography, ultrasonography, and magnetic resonance imaging can be helpful if the diagnosis remains unclear
- Injected corticosteroids can relieve pain, but should be used with caution
- Ultrasonography, shock wave therapy, orthotics, massage, and technique modification are treatment options, but few data exist to support their use at this time.
From the Research
Definition and Prevalence
- Distal triceps calcific tendinosis is not directly addressed in the provided studies, but calcific tendinosis in general is a condition where calcium deposits form in the tendons, leading to pain and limited mobility.
- Calcific tendinopathy is a common cause of shoulder pain, but it can also occur in other tendons, including the distal triceps tendon 2.
Diagnosis and Treatment
- The diagnosis of calcific tendinosis is typically made through a combination of clinical examination, imaging studies such as X-rays or MRI, and patient history 3, 2.
- Treatment options for calcific tendinosis include conservative management with physical therapy, pain management, and corticosteroid injections, as well as more invasive procedures such as ultrasound-guided percutaneous lavage (UGPL) and surgical debridement 3, 2, 4.
- UGPL is a commonly used treatment for shoulder calcific tendinosis, and has been shown to be effective in reducing calcium burden and pain while limiting soft-tissue damage 2.
Specific Considerations for Distal Triceps Tendon
- The distal triceps tendon is susceptible to injuries such as ruptures, which can be caused by falls, direct blows, or other traumatic events 5.
- Risk factors for distal triceps tendon injuries include local steroid injection, hyperparathyroidism, and olecranon bursitis 5.
- Treatment for distal triceps tendon injuries depends on the severity of the injury, and may include nonsurgical management for incomplete tears or surgical repair for complete tears 5.
Comparison of Treatment Options
- A study comparing the efficacy of triamcinolone acetonide and methylprednisolone acetonide for intrabursal injection after ultrasound-guided percutaneous treatment in painful shoulder calcific tendonitis found that both treatments were effective, but triamcinolone acetonide had a higher chance of reaching complete remission 6.
- The choice of treatment for calcific tendinosis depends on the individual patient's condition, medical history, and response to previous treatments, and should be made in consultation with a healthcare professional 3, 2, 4.