What is the most likely diagnosis? 
              
                - 61 year-old man with shoulder pain
 
              
                
                AP Radiograph of Shoulder
              
                - Heterotopic Ossification
 
                - Hydroxyapatite Deposition Disease
 
                - Calcinosis Universalis
 
                - Fracture of Greater Tuberosity
 
                - Metastatic prostate Cancer
 
              
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                  Answer:
               
              
                2. Hydroxyapatite Deposition Disease
                 
              
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              Hydroxyapatite Deposition Disease
                
              
              General Considerations
              
                - Calcium  phosphate crystals are deposited in the form of calcific tendinitis, other  periarticular hydroxyapatite deposition, and hydroxyapatite-induced arthritis 
 
                - May  be primary, such as calcific tendinitis and bursitis, or secondary, as in dystrophic  calcification in chronic renal disease or collagen vascular diseases
 
                - Most  common in middle aged men, slightly greater than women
 
                - The shoulder  is the most common site