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Paradiaphyseal calcific tendinitis with cortical bone erosion
P Fritz1, T Bardin, J D Laredo
1Clinique de Rhumatologie, Centre Viggo Petersen, Hôpital Lariboisière, Paris, France.
Arthritis and Rheumatism
|May 1, 1994
Summary
Calcific tendinitis can erode bone cortex, presenting as an uncommon form of apatite deposition disease. This condition involves calcium deposits causing bone erosion, often mimicking neoplasms.
Area of Science:
- Orthopedics
- Rheumatology
- Radiology
Background:
- Calcific tendinitis is a common condition characterized by calcium hydroxyapatite crystal deposition in tendons.
- Cortical bone erosion adjacent to calcific tendinitis is an unusual finding.
Purpose of the Study:
- To elucidate the clinical, radiological, and histological characteristics of calcific tendinitis accompanied by cortical bone erosion.
- To differentiate this entity from bone neoplasms.
Main Methods:
- Retrospective review of 6 patients diagnosed with paradiaphyseal calcific tendinitis and adjacent cortical bone erosion.
- Radiographic (plain film, CT) and bone scan imaging analysis.
- Histopathological examination including transmission electron microscopy and elemental analysis.
Main Results:
- Calcific tendinitis occurred at the linea aspera (4 patients), bicipital groove (1), and deltoid insertion (1).
- Cortical bone erosions were evident on plain radiographs (4 patients) and CT scans (2 patients).
- Histology revealed a foreign body reaction with giant cells surrounding apatite crystals.
Conclusions:
- Paradiaphyseal calcific tendinitis with cortical bone erosion represents an uncommon manifestation of apatite deposition disease.
- This presentation can mimic bone tumors, necessitating thorough investigation.