Clinical History •
62-year-old female presents with a slowly-enlarging mass at the medial aspect of the right foot
•
The mass is not painful but the increasing size has resulted in skin breakdown and difficulty with wearing shoes
Ultrasound of the Month – Case 39
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Ultrasound of the Month – Case 39
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Ultrasound of the Month – Case 39
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Ultrasound of the Month – Case 39
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Treatment
• While surgical excision was considered necessary due to the size of the lesion and worsening symptoms, pre-operative biopsy was requested to exclude malignancy and help in planning the surgical approach
Ultrasound of the Month – Case 39
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Ultrasound of the Month – Case 39
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Diagnosis
• Pathologic review of the samples obtained demonstrated calcific material without evidence of neoplasm
• Final diagnosis: Calcium hydroxyapatite deposition disease
Ultrasound of the Month – Case 39
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Hydroyapatite Deposition Disease
• Characterized by the deposition of calcium phosphate crystals (predominantly hydroxyapatite) in the peri-articular soft tissues • Most commonly found within tendons (calcific tendinosis) and especially within the rotator cuff • Local ischemia, trauma, metaboklic, and genetic
• The etiology of these depositions is uncertain. • Possible factors suspected include prior trauma, local ischemia and resulting soft tissue degeneration, metabolic factors, and a genetic predisposition.
Ultrasound of the Month – Case 39
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