Hydroxyapatite Deposition Disease- Spontaneous Resolution of Significant Post Treatment Deposit

Calcific deposits are commonly seen on imaging done for other reasons. However, it can also present with periarthritis and adhesive capsulitis leading to severe disabling pain. Many theories have been proposed to explain the etiology and it is considered idiopathic by some. The management is also debatable, Barbotage being the most popular. In the majority of the cases it disappears spontaneously, requiring intervention like Barbotage and surgery only in a few cases. We present a case of a 45 year old female patient who had these calcific deposits in an unusual location of her right shoulder. These disappeared partially on conservative treatment. Subsequently, she developed severe pain in her right shoulder with restriction of all her movements. The pain was severe enough to interfere with her sleep. As a result she underwent barbotage. During the procedure an attempt was made to aspirate the calcific deposit in its entirety. This was not possible due to clogging of needle several times. There was complete resolution of pain following the procedure. However, post-procedure Magnetic resonance imaging (MRI) revealed a significant residual calcification which completely resolved 02 months after therapy with no recurrence.