hydroxyapatite deposition disease; calcium hydroxyapatite deposition disease; basic calcium phosphate deposition disease; basic calcium phosphate-associated arthritis
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Etiology
- often occurs in the setting of trauma
Epidemiology
- mostly occurs in women
Pathology
- deposition of calcium hydroxyapatite in synovial joints & tendon sheaths
Clinical manifestations
- acute inflammation
- calcific tendonitis
- osteoarthritis
- periarthritis/arthritis dialysis syndrome
- rupture of calcinotic deposits in scleroderma
- chronic inflammation, chronic shoulder pain
- active motion is limited
- passive motion may be preserved
- may be asymptomatic
Laboratory
- synovial fluid
- individual crystals cannot be seen on routine polarization microscopy
- small, round bodies 0.5-100 um seen as lumps of crystals
- positive identification requires electron microscopy or elemental analysis
- Alizarin red staining for Ca+2 plus exclusion of CPPD provides presumptive diagnosis
- non-inflammatory: case[2] with 8300 leukocytes/uL
Radiology
- X-ray may show articular & periarticular dystrophic calcification
- X-ray of shoulder may show large effusion[2]
Differential diagnosis
Management
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Additional terms
References
- ↑ Mayo Internal Medicine Board Review, 1998-99, Prakash UBS (ed) Lippincott-Raven, Philadelphia, 1998, pg 862
- ↑ 2.0 2.1 2.2 2.3 2.4 2.5 Medical Knowledge Self Assessment Program (MKSAP) 16, 17, 18, 19. American College of Physicians, Philadelphia 2012, 2015, 2018, 2022.
Medical Knowledge Self Assessment Program (MKSAP) 20 American College of Physicians, Philadelphia 2025