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Calcific tendinitis at the MCP joint of the thumb in a young male
Chloe Coulter
Dr. Luis Quiroga, MD, MPH
Dr. Kerri Woodberry, MD, MBA, FACS
West Virginia University School of Medicine
2022-01-15
Presenter: Chloe Coulter
Affidavit:
I certify this is original material and has not been published.
Director Name: Kerri Woodberry MD
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: Hand
Introduction: Acute calcific tendinitis is a relatively rare self-limited inflammatory condition at joints or tendons commonly described within the rotator cuff and hips. Most cases are seen predominantly in middle-aged women. There are fewer reports detailing calcific tendinitis of the hands and digits, especially in young males.
Case Presentation: We present a case of a 24-year-old male complaining of a two-month history of a mass on the right MCP joint of the thumb associated with pain. He participates in mixed martial arts and intense workout regimens but was unsure of any trauma to the area. Physical examination revealed a non-tender small, mobile, fluid-like mass located at the radial aspect of his right thumb MCP. X-ray imaging was consistent with soft tissue calcification. Upon four-week follow-up of conservative treatment with thumb splint spica and a combination of Tylenol and ibuprofen, the patient reported significantly improved pain with residual discomfort of the radial aspect of his right thumb MCP joint with direct pressure and during opposition of the right thumb. This correlated with a radiographic improvement.
Discussion: The pathophysiologic mechanism of calcific tendinitis is unclear, but a three-stage cell-mediated process of calcifications within the tendon following repetitive strain has been well described. Because older females are more affected, this case in a male patient required a high index of suspicion to make the diagnosis after excluding other etiologies. Because calcific tendinitis can mimic an infection with erythema, swelling, and tenderness, it is important to recognize this entity and avoid surgical treatment.
