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  • 1. PROF MAHESHKUMAR’S UNIT DR R VIJAYANAND
  • 2. 55 years old gentleman from Rajasthan comes with h/o recurrent respiratory infections
    • No h/o prior antituberculous therapy
    • Non smoker
  • 3.  
  • 4.  
  • 5. Chest xray PA View showing
    • Multiple soft tissue calcification
    • Multiple healed parenchymal lesions
    • Calcified worm
    • bronchiectasis
  • 6. Causes for soft tissue calcification DYSTROPHIC Diseased tissue Normal serum CALCIUM Damaged heart valves TB LYMPH NODES Atherosclerosis Stroma of some tumours < psammoma bodies >
    • METASTATIC
    • Normal tissues
    • Disorder of calcium metabolism
    • CKD
    • Hyperparathyroidism
    • Sarcoidosis
    • Milk alkali syndrome
    • HyperVitaminosis D
    • Commonly seen in kidneys<basement membranes>
    • Lungs<alveolar walls
    • Stomach-fundal glands
    • cornea
  • 7. Soft tissue calcification
    • Arterial calcification-aging,primary or secondary hyperparathyroidism,werner’s syndrome.
    • Venous calcification-thrombosed veins, varicose veins
    • Nerves- leprosy,neurofibromatosis
    • Haematomas- cephal haematomas
  • 8.
    • Metabolic - hyperparathyroidism, vit-D overdose, chronic renal failure
    • Soft tissue necrosis followed by calcification
    • Subcutaneous fat necrosis & calcification – ehlers danlos syndrome , christian weber syn
    • Extensive soft tissue calcification in dermatomyositis – ‘calcinosis universalis’
    • -TB lymph node,Im injections, snakebites,frost bite,
  • 9.
    • Tendon – supraspinatus tendon
    • Diffuse systemic sclerosis
    • Calcification of tumours- haemangiopericytoma, medullary carcinoma of thyroid, thyroid adenoma
    • Parasitic calcification-guinea worm, loa loa, cysticercus cellulosae, trichinella spiralis
  • 10. Guinea worm [Dracunculensis medinensis]
    • Vector borne nematode infestation of soft tissue
    • Common in gujarat, rajasthan
    • Last case in india july - 1996
    • India declared free of guinea worm - 2000
  • 11. LIFE CYCLE
    • drinking water infected
    • With cyclops
    • Man acquires infection
    • Larvae released & penetrate the duodenal wall
    • Larvae Mature&reproduce
    • Migrates through viscera to subcutaneous tissues
    • Fertilzed female worm migrates to skin surface
    • Causes blister ruptures releases larvae
  • 12.
    • Where stepwells are the source of water supply
    • Transmission occurs
    • Eradication is possible by provision of safe drinking water, control of cyclops,health education
    • Treatment – Niridazole,Mebendazole,Metronidazole
    SOFT TISSUE SWELLINGS WORM FROM BLISTER
  • 13. References
    • Sutton textbook of radiology
    • Park textbook of social&preventive medicine
    • Fishman textbook of respiratory diseases
    • Internet
    • Robbins textbook of pathology
  • 14.