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Hydroxyapatite crystal deposition disease
Glenn M Garcia1, Gary C McCord, Rajendra Kumar
1Department of Radiology, University of Texas Health Science Center, San Antonio, TX 78229-3900, USA.
Insights
Hydroxyapatite (HA) crystal deposition disease (HADD) involves HA crystal buildup in joints, causing pain and swelling. Treatment includes pain relief, aspiration of deposits, and sometimes surgery.
Area of Science:
- Rheumatology
- Orthopedics
- Crystal Arthropathies
Background:
- Hydroxyapatite (HA) crystal deposition disease (HADD) is a systemic condition of unknown cause.
- It results from the deposition of HA crystals in or around joints, leading to inflammation and pain.
Purpose of the Study:
- To describe the clinical manifestations, radiographic findings, and treatment options for HADD.
- To highlight the common involvement of the shoulder joint and its association with Milwaukee shoulder.
Main Methods:
- Review of clinical cases and radiographic evidence of HADD.
- Analysis of the distribution and characteristics of HA crystal deposits.
- Evaluation of treatment outcomes for various interventions.
Main Results:
- HADD presents with localized pain, swelling, and limited joint motion, though some patients are asymptomatic.
- Radiographs often reveal calcifications in tendons, bursae, and joint capsules, with the shoulder (supraspinatus tendon) being most commonly affected.
- Intra-articular HA crystals can lead to joint destruction, as seen in Milwaukee shoulder.
Conclusions:
- HADD is a significant cause of joint pain and dysfunction, particularly affecting the shoulder.
- Early diagnosis and appropriate management, including analgesics, aspiration, and injections, are crucial for symptom relief.
Abstract:
Hydroxyapatite (HA) crystal deposition disease (HADD) is a well-recognized systemic disease of unknown etiology that is caused by para-articular and/or intra-articular deposition of HA crystals. The disease is clinically manifested by localized pain, swelling, and tenderness about the affected joint along with variable limitation of joint motion, although not all patients are symptomatic. Plain radiographs may show calcifications of varying size and shape in the para-articular tendons, bursae, and capsule. The disease may be mono- or polyarticular in distribution. The shoulder is most commonly involved with calcification in the supraspinatus tendon. When intra-articular, HA crystals can cause joint destruction. Any joint can be involved; the shoulder is most commonly affected, resulting in "Milwaukee shoulder." Treatment of HADD usually requires use of analgesics, local heat, needling with or without aspiration of the calcific deposits, steroid injections, and, at times, even surgery for relief of pain.
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