Acute severe hip pain associated with labral calcific deposition disease

Calcific tendinitis is a term used to describe radiographic evidence of calcific deposition within a tendon. This condition, also known as calcium deposition disease, has been described in the gluteus maximus, the peroneus longus tendon, the popliteus tendon, the longus colli muscle in the neck, and the tendon of the rectus femoris. However, most of the literature on calcific tendinitis relates to crystal deposition within the rotator cuff of the shoulder. The peri-articular pain related to calcium deposition may be indolent and chronic, and patients can have varying degrees of functional deficit. Patients also may present with an acute inflammatory event, with severe incapacitation and restricted passive range of motion and a clinical picture that is concerning for septic arthritis. Severe pain associated with calcific tendonitis usually occurs during the resorptive phase, where there is vascular infiltration of the calcium deposits and histologic evidence of phagocytosis. The authors report a case of calcium deposition disease found within the hip labrum with a clinical presentation of acute, atraumatic, debilitating pain in a patient with underlying femoroacetabular impingement. This clinical picture is similar to that described during the resorptive phase seen in calcific tendonitis of the shoulder. The authors attribute this presentation to acute rupture of the calcium deposit into the intra-articular joint space of the hip. To the authors' knowledge, there are no other reports of this clinical presentation in the literature.