Clinical Images: Osseous involvement in calcific tendinitis: unusual in the usual

62-year-old male, consulting for ongoing pain in the right shoulder, noticeable on performance of daily tasks. Physical examination demonstrates generalized pain with mobilization, more marked with external rotation, and limited abduction, with a mechanical block at 60 degrees. Oblique-Sagittal Short-TI inversion recovery (STIR) (figure 1) demonstrates a low signal intensity structure at the footprint of the infraspinatus (white arrow). This has an extra and an intraosseous component, resembling an hourglass. Adjacent to the intraosseous component, there is hyperintensity of the bone marrow, consistent with edema, and also a surrounding region of hyperintensity, representing edema, in the soft tissues. This article is protected by copyright. All rights reserved.