Ultrasound Findings in Symptomatic HADD of the Hand and Wrist. A Case Series of 37 Patients

PURPOSE: To present a series of 37 cases diagnosed with ultrasound (US) of symptomatic hydroxyapatite deposition disease (HADD) involving the wrist and hand. MATERIALS AND METHODS: Reports from two institutions were searched using the keywords "HADD hand/wrist" or "calcium deposit hand/wrist". The US examinations were performed with a similar standardized approach, focusing on the region of pain. B-mode and Doppler sonograms were acquired. Each author reviewed the cases to ensure that only cases consistent with HADD were included. RESULTS: A total of 37 patients were identified, mostly women (81% of the cases). The mean age was 50 years old. Calcifications usually showed resorptive stage features (type III). Follow-up clinical data were available in 16 patients, mostly with at least a partial resolution of symptoms. CONCLUSION: US is a useful imaging technique to diagnose HADD of the hand and wrist, especially in the correct clinical context (e.g., acute non-traumatic symptoms in women, with progressive improvement in pain). Conventional radiography may help to confirm the calcific deposit. Advanced imaging modalities are usually not required, but may be considered in selected cases. Follow-up to confirm an improvement over time is suggested.