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Hydroxyapatite deposition disease

Case contributed by Liz Silverstone
Diagnosis almost certain

Presentation

Acute non-traumatic right elbow pain

Patient Data

Age: 30
Gender: Male

Focal ovoid calcification projected lateral to the capitellum.

  • ovoid low signal intensity corresponds with the calcification and lies deep to the common extensor tendon at the posterior margin of the lateral collateral ligament

  • surrounding high T2 signal intensity indicates soft-tissue edema

US-guided aspiration

ultrasound
  • echogenic calcified body

  • 19G barbotage needle

  • calific material aspirated and ropivicaine injected

Case Discussion

Typical features of hydroxyapatite deposition disease (HADD) in the periarticular soft-tissue.

Good pain relief following procedure.

Superficial steroid injection which can cause subcutaneous fat atrophy.

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