Apatite is the primary mineral of normal bone and teeth. Abnormal accumulation can occur in a wide range of clinical settings (Table 167-2 Conditions Associated with Apatite Deposition Disease). Apatite is an important factor in Milwaukee shoulder, a destructive arthropathy of the elderly that occurs in the shoulders and knees. Apatite crystals are small; clumps may stain purplish on Wright's stain and bright red with alizarin red S. Definitive identification requires electron microscopy or x-ray diffraction studies. Radiographic appearance resembles CPPD disease. Treatment: NSAIDs, repeated aspiration, and rest of affected joint.