Calcific Tendinitis: A Pain-Oriented and Site-Specific Narrative Review

Calcific tendinitis is a common musculoskeletal disorder characterized by deposition of calcium hydroxyapatite within or around tendon tissue. Although it has traditionally been regarded as a structural tendon pathology, growing clinical evidence suggests that symptom severity, particularly pain, is more closely related to inflammatory activity and disease stage than to the size or precise anatomical location of calcific deposits. In routine practice, patients most often seek medical attention during sudden and intense pain episodes, typically occurring in the resorptive phase. Current diagnostic frameworks and treatment strategies are largely derived from studies on rotator cuff calcific tendinitis. In contrast, calcific tendinitis involving nonrotator cuff sites remains under-recognized and is frequently misdiagnosed. These atypical presentations commonly manifest with acute inflammatory pain that mimics infection, fracture, or inflammatory arthropathy, often resulting in diagnostic confusion and unnecessary interventions. This narrative review adopts a pain-oriented, site-specific framework to examine calcific tendinitis, with emphasis on nonrotator cuff involvement. By integrating pain presentation, disease stage, and targeted imaging, we highlight a symptom-driven approach to diagnosis and management. Conservative care with site-specific rehabilitation remains fundamental, while invasive treatments should be reserved for refractory pain.