Acute calcific tendinitis of the flexor carpi ulnaris causing acute compressive neuropathy of the ulnar nerve: a case report

This study reports a case of acute calcific tendinitis of the flexor carpi ulnaris in a 64-year-old woman. She presented with symptoms of acute ulnar nerve compression mimicking a volar compartment syndrome. Owing to rapidly progressive symptoms, emergency surgical exploration was carried out. Intra-operatively a large mass of calcium phosphate carbonate was noted in association with the flexor carpi ulnaris near its insertion at the wrist compressing the ulnar nerve and artery in Guyon's canal. Postoperatively the patient had complete resolution of symptoms. Conservative management with non-steroidal anti-inflammatory drugs, rest, splinting, and steroid therapy is recommended for acute calcific tendinitis, but this case suggests a role for surgical treatment when there is acute neural compression and severe pain.