CLINICAL IMAGAGINGAN ATLAS OF DIFFERENTIAL DAIGNOSISEISENBERG

1. 18Generalized Calcification or
Ossification in Muscles and
Subcutaneous Tissues

2. CLINICAL IMAGAGING
AN ATLAS OF DIFFERENTIAL DAIGNOSIS
EISENBERG
DR. Muhammad Bin Zulfiqar
PGR-FCPS III SIMS/SHL

3. • Fig B 18-1 Dermatomyositis. Extensive
deposits of calcium in the soft tissues about
the humerus and elbow and loss of the sharp
demarcation between the muscles and the
subcutaneous tissues.

4. • Fig B 18-2 Scleroderma. Extensive calcifications
about the hip joint and proximal femur.

5. • Fig B 18-3 Calcinosis universalis. Huge calcified
mass in the subcutaneous and deep
connective tissues of the lower leg.

6. • Fig B 18-4 Hypervitaminosis D. Diffuse
calcification involving the interosseous ligament
between the tibia and fibula as well as vascular
structures

7. • Fig B 18-5 Hypervitaminosis D. Huge masses of
calcification near the shoulder joints
bilaterally.

8. • Fig B 18-6 Hypoparathyroidism. Soft-tissue
calcifications lying in muscle bundles about
both hip joints.

9. • Fig B 18-7 Arteriosclerosis of the lower
extremities. There are calcified plaques
(arrows) in the walls of aneurysms of the
lower abdominal aorta and both common iliac
arteries.

10. • Fig B 18-8 Mönckeberg's sclerosis. Typical
calcification of the media in moderate-sized
vessels of a diabetic patient. Note the prior
surgical resection of the phalanges of the
fourth digit.

11. • Fig B 18-9 Varicose veins. Multiple, round and
oval calcifications in the soft tissues (phleboliths)
representing calcified thrombi, some of which
have characteristic lucent centers (black arrows).
Extensive new bone formation along the medial
aspect of the tibial shaft (white arrows) caused by
long-standing vascular stasis.

12. • Fig B 18-10 Soft-tissue hemangiomas with
phleboliths involving (A) the thumb and (B)
the forearm.

13. • Fig B 18-11 Maffucci's syndrome. (A) Plain
radiograph demonstrates multiple soft-tissue
masses and calcified thrombi in association with
expansile bony lesions. (B) Late film from an
arteriogram shows contrast material filling many
cavernous hemangiomas of the soft tissues.

14. • Fig B 18-12 Systemic lupus erythematosus.
Lace-like calcification about the elbow.

15. • Fig B 18-13 Pseudoxanthoma elasticum.
Extensive calcification in soft tissues on the
radial side of the wrist.

16. • Fig B 18-14 Cysticercosis. Multiple, linear and
oval calcifications along muscle bundles.

17. • Fig B 18-15 Myositis ossificans progressiva.
Frontal view of the chest demonstrates
extensive new bone formation in the soft
tissues, which severely limited arm motion.
Note the exostosis of the left proximal
humerus due to blending of the ossific foci
with the cortex of the bone.31

18. • Fig B 18-16 Fluorosis. Calcification of the
sacrotuberous ligaments (arrows).