Calcific Tendinitis of the Linea Aspera with Bilateral Deposits and Inflammatory Asymmetry Presenting as Unilateral Pain: A Case Report and Review of Literature.

INTRODUCTION: Calcific tendinitis (hydroxyapatite deposition disease) most commonly affects the shoulder and peri-trochanteric hip region. Involvement of the linea aspera is uncommon and may mimic aggressive pathology due to associated cortical reaction and marrow edema. CASE REPORT: A 53-year-old female presented with predominantly right-sided upper thigh pain. Radiographs demonstrated amorphous calcification along the lateral proximal femur at the linea aspera. Magnetic resonance imaging showed a calcific focus with marked adjacent marrow and soft-tissue edema on the right, while the contralateral side demonstrated minimal muscular hyperintensity without a definite calcific focus. Computed tomography (CT) confirmed bilateral intratendinous calcific deposits, with a larger deposit on the symptomatic right and a tiny 2.5 mm deposit on the asymptomatic left. Conservative management resulted in complete symptom resolution. CONCLUSION: Calcific tendinitis of the linea aspera may be bilateral despite unilateral symptoms and can exhibit marked inflammatory asymmetry. CT is essential for confirming intratendinous calcification and avoiding misdiagnosis as infection or malignancy.