From the Research
Hydroxyapatite deposition disease (HADD) is a clinically significant condition that causes painful inflammatory reactions when calcium hydroxyapatite crystals deposit in periarticular soft tissues, particularly around the shoulder, and its management focuses on symptom relief with NSAIDs, corticosteroid injections, and physical therapy. The condition typically presents as acute, severe pain and restricted joint movement, often mimicking other conditions like rotator cuff tears or adhesive capsulitis 1. HADD most commonly affects middle-aged to elderly individuals, with the rotator cuff tendons being the most frequent site, though it can occur in other locations including the hip, elbow, wrist, and knee 2.
Key Points
- HADD is a self-limiting condition, but symptoms can be severe and debilitating, requiring prompt management 3.
- Treatment focuses on symptom management with NSAIDs like ibuprofen (600-800mg three times daily) or naproxen (500mg twice daily) for 1-2 weeks during acute episodes 1.
- Corticosteroid injections may be beneficial for persistent pain, typically using triamcinolone acetonide (40mg) or methylprednisolone (40-80mg) mixed with local anesthetic 4.
- Physical therapy is important for maintaining range of motion once acute pain subsides 2.
- Understanding HADD is crucial for clinicians to avoid misdiagnosis and unnecessary interventions, as its symptoms can be mistaken for more serious conditions requiring surgical management 5.
Recent Evidence
The most recent study 1 highlights the importance of early diagnosis and treatment of HADD to prevent long-term morbidity and improve quality of life. Another recent study 4 demonstrates the effectiveness of ultrasound-guided barbotage as a minimally invasive procedure for managing HADD-related calcific periarthritis.
Management Approach
The management approach for HADD should prioritize symptom relief and functional restoration, with a focus on conservative management using NSAIDs, corticosteroid injections, and physical therapy 3. In cases where conservative management fails, CT-guided treatment may be considered as a viable option 3.