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Joseph Junewick, MD FACR
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Calcinosis Universalis

Case Detail

Anatomy: Musculoskeletal
Junewick
Joseph Junewick, MD FACR
Diagnostic Category: Infectious-Inflammatory
Created: over 5 years ago
Updated: over 5 years ago
Tags: PEDS
Modality/Study Types: CR
Activities:
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History

15 year old female with dermatomyositis.


Case Images


Diagnosis

Calcinosis Universalis

Findings

CR – Amorphous sheets of calcium along the extensor tendons and fascia of the left wrist and ankle.

MR – Peritendinous aggregates of calcium along the radial extensor tendons of the left wrist.

Discussion

The term calcinosis universalis refers to diffuse, sheetlike deposition of calcium involving the muscles, subcutaneous tissues, and fascial planes. Calcinosis universalis is most commonly associated with connective tissue disease, primarily polymyositis and dermatomyositis but rarely systemic lupus erythematosus. The characteristic sheetlike distribution of calcinosis universalis and its involvement of muscle and fascial planes usually in the extremities at sites of repetitive trauma makes this condition distinct from tumoral calcinosis at imaging. Serum calcium, phosphorus and parathyroid levels are normal. Skin ulceration, contractures, arthralgias and muscle atrophy may result. Medications (such as corticosteroids, immunoglobulin, cyclosporin, NSAIDs) and surgical treatment (laser and excision) have had some effect.

Reference

Olsen KM, Chew FS. Tumoral Calcinosis: Pearls, Polemics, and Alternative Possibilities. RadioGraphics (2006); 26, 871-885.



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