Calcific Tendinosis Mimicking Septic Arthritis and Myositis: Case Report and Literature Review

Authors

  • Sara Hachem MD Department of Rheumatology, Lebanese Hospital Geitaoui-UMC, Faculty of Medical Science-Lebanese University, Beirut
  • Amani Al-Abed MD Department of Rheumatology, Lebanese Hospital Geitaoui-UMC, Faculty of Medical Science-Lebanese University, Beirut
  • Oussama Fakih MD Department of Rheumatology, Lebanese Hospital Geitaoui-UMC, Faculty of Medical Science-Lebanese University, Beirut
  • Nicolas Sandakly MD Department of Rheumatology, Lebanese Hospital Geitaoui-UMC, Faculty of Medical Science-Lebanese University, Beirut
  • Ouidade Aitisha Tabesh MD, MSc Department of Rheumatology, Lebanese Hospital Geitaoui-UMC, Faculty of Medical Science-Lebanese University, Beirut/ Division of Rheumatology, Department of internal Medicine, Lebanese American University Gilbert and Rose-Marie Chagoury School of Medicine, Byblos, Lebanon
  • Fouad Fayad MD, PhD, FRCPG Department of Rheumatology, Lebanese Hospital Geitaoui-UMC, Faculty of Medical Science-Lebanese University, Beirut/ Division of Rheumatology, Department of internal Medicine, Lebanese American University Gilbert and Rose-Marie Chagoury School of Medicine, Byblos, Lebanon

DOI:

https://doi.org/10.3941/jrcr.6092

Abstract

Hydroxyapatite deposition disease (HADD) is a crystal-induced condition that most commonly affects the shoulder, leading to rotator cuff tendinopathy. It rarely involves the hip joint and causes gluteus medius tendinitis, making diagnosis in such cases particularly challenging.

We report the case of a 54-year-old female patient who presented with acute, severe right hip pain and restricted mobility. Imaging and laboratory findings suggested right coxofemoral arthritis and focal myositis. Further evaluation revealed multifocal calcific tendinopathies, including a ruptured calcific tendinopathy of the gluteus medius tendon. Ultrasound-guided arthrocentesis ruled out septic arthritis.

The patient responded dramatically to colchicine, with rapid improvement in both pain and mobility. This case highlights the importance of considering HADD in the differential diagnosis of acute monoarthritis, particularly in atypical sites, and underscores the diagnostic value of bimodal imaging. 

 

Pelvic radiograph showing calcific deposits at the gluteus medius insertion (arrows).

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Published

2026-06-15

Issue

2026: Articles in Press

Section

Musculoskeletal Radiology

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