1. MedPix Medical Image Database COW - Case of the Week Case Contributor: Browyn P Richards Affiliation: National Naval Medical Center Bethesda

2. MedPix No: 9241 - History Pt Demographics: Age = 35 y.o. Gender = woman Patient recently completed steroid treatment for unknown disorder reports sudden onset of non-traumatic bilateral shoulder pain. Downloaded by (-1)

3. MedPix No: 9241 - EXAM & LABS Shoulder pain with motion. No labs obtained.

4. Calcific Tendinitis Externally rotated right shoulder demonstrating focal calcification within the superspinatus tendon. Also, note calcific density projecting over the humeral head in the region of the lesser tuberosity. Downloaded by (-1)

5. Calcific Tendinitis Externally rotated left shoulder demonstrating focal calcification within the superspinatus tendon. Also, note calcific density projecting over the humeral head in the region of the lesser tuberosity. Downloaded by (-1)

6. Calcific Tendinitis Internally rotated right shoulder demonstrating calcification within the infraspinatis tendon. Also, note calficic density projecting over the humeral head in the region of the greater tuberosity. Downloaded by (-1)

7. Calcific Tendinitis Internally rotated left shoulder demonstrating calcification within the infraspinatus tendon. Also, note calcific density projecting over the humeral head in the region of the greater tuberosity. Downloaded by (-1)

8. FINDINGS Calcification in the bilateral shoulders in the region of the supraspinatus and infraspinatus tendons.

9. DIFFERENTIAL DIAGNOSIS What is your Differential Diagnosis? For shoulder pain: - - Acromoclavicular joint arthritis - - Adhesive capsulitis - - Cervical spondylosis - - Impingement syndrome - - Rheumatoid arthritis - - Rotator cuff tear - - Septic Joint - For the imaging findings: Loose bodies

10. Diagnosis: Bilateral supraspinatus and infraspinatus calcific tendinitis. Dx Confirmed by: Plain radiographs.

11. DISCUSSION None.