16- Hydroxyapatite Deposition Disease (HADD) Flashcards
What is it and what are the clinical features of HADD.
pg 1099
− M=F, 40-70 age range
− See tendonitis, bursitis, joint pain
− Deposition of hydroxyapatite in soft tissues
− Shoulder most common joint affected (supraspinatus tendon)
− Also affects hip, upper cervical spine
− Pain, tenderness, swelling, decreased ROM
What are the pathologic features of HADD?
- unknown cause
- could be genetics, age, biomechanics and trauma all could influence.
- tisse death is seen at site of crystal deposition
- Supraspinous tendon “critical zone”
What are the radiographic features?
- tendon calcification–> near insertion and doesn’t blend into the cortex of near bone.
- Homogeneous opacity (same white look the whole way through-consistent)
- Bursal Calcification–> always round or oval, most common are subacromial, sub deltoid, and ischial bursae.
txt:
-most common site: shoulder, spine and hip
Shoulder: Supraspinatus most common, seen in external rotation
-infraspinatus, terres minor on internal rotation
Hip: Glut max most common below lesser trochanter
Spine: Longus colli anterior to C1 and C2
Nucleus Pulposus: calcification in either child or adult
-calcification associated with widened disc space and flattened adjacent vertebral bodies in acute phase
Targeted site of involvement:
Shoulder
− Seen in 3% of population
− 50% are bilateral, right 2x more common − Supraspinatus, infraspinatus, teres minor,
subscapularis
− Biceps, subdeltoid/acromial bursa
Targeted sites of involvement
Hip
1102
− Calcification in gluteus max, below lesser trochanter, over femoral shaft − Can see at AIIS, acetabular margin, ischial tuberosity
Targeted sites of Involvment
Cervical spine
- 2 anatomic sites in spine for hydroxyapatite deposition have been identified: the longs collie muscle and the intervertebral disc. anterior to C1/C2
- See calcified disc in: DDD, block vertebrae, idiopathic HADD, ochronosis.
