calcium hydroxyapatite crystal deposition disease ( RID3594 )
XR 3 weeks earlier reported Normal. There is smooth erosion and minimal marrow edema (arrow) at the supraspinatus insertion, which is not the typical cystlike change and spurring we see in insertional tendinosis. It suggested HADD to me, but I wasnt sure if there were small intrasubstance calcifications. HADD becomes acutely symptomatic in the resporptive phase which lasts for weeks. When we are left with reactive inflammatory change after calcifications resorb, proper diagnosis can be elusive. In this case, XRs 3 weeks earlier clearly show supraspinatus calcific deposits. I know many of us are drowning in XR volume, but if we dont actually look at the XR and report them accurately, its a waste of good radiation.

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