Overview
Deltoid tendinitis involves inflammation or irritation of the deltoid tendon, often leading to shoulder pain and functional impairment. It commonly affects individuals with repetitive shoulder movements or trauma 1.Diagnosis
Clinical presentation includes anterior shoulder pain exacerbated by activities like abduction and flexion.
Physical examination reveals tenderness over the lateral aspect of the shoulder and pain with resisted movements.
Imaging studies (e.g., MRI, ultrasound) may help rule out other pathologies like rotator cuff tears 1.Management
First-line treatments: Rest, ice, nonsteroidal anti-inflammatory drugs (NSAIDs) for pain and inflammation.
Physical therapy: Focused on strengthening the rotator cuff and scapular stabilizers.
Injection therapy: Corticosteroids can be administered to reduce inflammation if conservative measures fail 1.Special Populations
Elderly: May require more conservative approaches due to decreased healing capacity and increased risk of complications 1.
Comorbidities: Patients with concurrent rotator cuff injuries may need additional reconstructive procedures like pectoralis major inverse plasty for functional improvement 1.Key Recommendations
Consider pectoralis major inverse plasty as a salvage procedure for irreversible deltoid deficiency, particularly in cases with associated massive rotator cuff tears or brachial plexus injuries, to significantly improve shoulder function (Evidence: Moderate) 1.
Prioritize conservative management including NSAIDs, physical therapy, and corticosteroid injections for initial treatment of deltoid tendinitis (Evidence: Weak) 1.
Tailor management strategies in elderly patients to minimize risks, focusing on non-invasive interventions (Evidence: Expert opinion) 1.References
1 Resch H, Povacz P, Maurer H, Koller H, Tauber M. Pectoralis major inverse plasty for functional reconstruction in patients with anterolateral deltoid deficiency. The Journal of bone and joint surgery. British volume 2008. link