Hydroxyapatite Deposition Disease (HADD) - MSK Radiology
Imaging ...

Hydroxyapatite Deposition Disease (HADD) - MSK Radiology
Imaging Findings:
 • Ovoid hypointense structures along the bursal surface of the superior cuff footprint attachment consistent with Calcium Hydroxyapatite deposits.
 • Fluid-like signal seen within the deltoid muscle fibers and soft-tissues adjacent to the Calcium Hydroxyapatite deposits consistent with myositis.
 • T2-hyperintense fluid-signal is seen within the subacromial/subdeltoid bursa consistent with bursitis.
Case description:
 • Hydroxyapatite Deposition Disease is a broad spectrum of musculoskeletal pathology due to crystal deposition.
 • This is generally monoarticular with inhomogeneous calcifications which are generally round/ovoid and faint on radiograph.
 • MRI shows globular low-signal on all sequences with surrounding hyperintense signal of the soft-tissues.
    - Deposits may show blooming on gradient-echo imaging with abnormal signal in the adjacent cuff.
    - Limits evaluation of cuff pathology (i.e. lower specificity of tear diagnosis)
 • Milwaukee shoulder:
    - Generally elderly women with severe destructive arthropathy of the shoulder with hydroxyapatite deposition in the synovial fluid.
 • Treatment for HADD: generally conservative. They may be needled, lavaged, and aspirated with variable results.
Differential diagnosis:
 • Dystrophic calcifications from other systemic disorders: Progressive systemic sclerosis, hyperparathyroidism, etc.
 • Tendinopathy or tenosynovitis: Differentiate low-signal normal tendon from globular low-signal Hydroxyapatite deposits.

Dr. Donald von Borstel @DrvonBorstel

#HADD #Hydroxyapatite #Deposition #Disease #clinical #mri #clinical #Radiology #diagnosis #msk 
Contributed by

Dr. Gerald Diaz
Board Certified Internal Medicine Hospitalist, GrepMed Editor in Chief 🇵🇭 🇺🇸 - Sign up for an account to like, bookmark and upload images to contribute to our community platform. Follow us on IG:  https://www.instagram.com/grepmed/ | Twitter: https://twitter.com/grepmeded/

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