Skeletal Radiology

, Volume 44, Issue 10, pp 1403–1412 | Cite as

Intraosseous migration of tendinous calcifications: cortical erosions, subcortical migration and extensive intramedullary diffusion, a SIMS series

  • Jacques MalghemEmail author
  • Patrick Omoumi
  • Frédéric Lecouvet
  • Bruno Vande Berg
Review Article


Calcium hydroxyapatite crystal deposition is a common disorder, which sometimes causes acute pain as calcifications dissolve and migrate into adjacent soft tissue. Intraosseous calcium penetration has also been described. We illustrate the appearance of these lesions using a series of 35 cases compiled by members of the French Society of Musculoskeletal Imaging (Société d’Imagerie Musculo-Squelettique, SIMS). The first group in our series (7 cases) involved calcification-related cortical erosions of the humeral and femoral diaphyses, in particular at the pectoralis major and gluteus maximus insertions. A second group (28 cases) involved the presence of calcium material in subcortical areas. The most common site was the greater tubercle of the humerus, accompanying a calcifying tendinopathy of the supraspinatus. In addition, an extensive intramedullary diffusion of calcium deposits was observed in four of these cases, associated with cortical erosion in one case and subcortical lesions in three cases. Cortical erosions and intraosseous migration of calcifications associated with calcific tendinitis may be confused with neoplasm or infection. It is important to recognize atypical presentations of hydroxyapatite deposition to avoid unnecessary investigation or surgery


Calcific tendinitis Periarthritis Hydroxyapatite Intraosseous lacunae MRI CT 



The presented series was collected thanks to the participation of several members of the French-speaking Society of Musculo-skeletal Imaging (Société d’Imagerie Musculosquelettique, SIMS): S. Bianchi, A. Cotten, O. Fantino, O. Hauger, JD. Laredo, G. Morvan, and V. Vuillemin, allowing us to gather the second most important series of intraosseous migrations of tendinous calcifications in the literature.

Conflicts of interest

The authors declare that they have no conflicts of interest regarding this study.


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Copyright information

© ISS 2015

Authors and Affiliations

  • Jacques Malghem
    • 1
    Email author
  • Patrick Omoumi
    • 1
  • Frédéric Lecouvet
    • 1
  • Bruno Vande Berg
    • 1
  1. 1.Département de radiologie et d’imagerie médicaleUniversité Catholique de LouvainBruxellesBelgium

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