16 periarticular calcification

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This document discusses various types of periarticular calcification seen on clinical imaging: 1) Calcific tendinitis is seen as amorphous calcium deposits in the supraspinatus tendon on shoulder imaging. 2) Hyperparathyroidism can cause dense masses of tumoral calcification in joint capsules and soft tissues, as seen in the foot of a patient with renal osteodystrophy. 3) Scleroderma is associated with clumps of calcification around shoulder joints, along with reticulonodular lung patterns and surgical clips from treatment of Raynaud's phenomenon.

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

• Fig B 16-1 Calcific tendinitis. Frontal view of
the shoulder demonstrates amorphous
calcium deposits (arrows) in the supraspinatus
tendon.

• Fig B 16-2 Hyperparathyroidism. Dense mass of tumoral
calcification in joint capsules and periarticular soft tissues of the
lateral aspect of the foot in a patient with renal osteodystrophy.

• Fig B 16-3 Scleroderma. Clumps of calcification
about the shoulder joints (arrows). Note the
reticulonodular interstitial pattern at both lung
bases. The surgical clips overlying the right apex
are from a cervical sympathectomy for the
treatment of associated Raynaud's phenomenon.

• Fig B 16-4 Tumoral calcinosis. (A) Supine view
demonstrates a large, irregular calcific mass with
some relatively lucent areas in the proximal thigh.
(B) Upright view shows sedimentation in the
liquid-filled cysts (arrow), with absence of
sedimentation in the more amorphous gritty
deposits.29

• Fig B 16-5 Calcinosis universalis. Dense calcific
deposits in the soft tissues on the ulnar aspect
of the thumb.

Fig B 16-6 Gout. (A) Frontal and (B) lateral views demonstrate
massive deposition of calcium in a long-standing tophaceous
lesion about the elbow.

• Fig B 16-7 Myositis ossificans. Marked heterotopic
bone formation about the hip joint in a patient with
paralysis.

Fig B 16-8 Pellegrini-Stieda disease. Post-traumatic ossification
(arrows) along the femoral condyle.

Radiolucent metaphyseal bands can be seen in several conditions: 1) Congenital syphilis presents with transverse bands of increased density across the metaphyses and patchy bone destruction in the diaphyses. 2) Rubella shows alternating lucent and sclerotic longitudinal striations perpendicular to the epiphyseal plate. 3) Leukemia displays radiolucent metaphyseal bands in addition to frank bone destruction and cortical erosion of many bones.

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This document discusses localized periosteal reactions seen on radiographs in a variety of conditions: 1) Osteogenic sarcoma, Ewing's sarcoma, and lymphoma can present with irregular periosteal responses and bone destruction. Ewing's sarcoma specifically shows laminated and thin periosteal elevations. 2) Chronic leukemia causes pronounced periosteal new bone formation around long bones. 3) Other conditions like aneurysmal bone cyst, chronic osteomyelitis, Reiter's syndrome, vascular stasis, Caffey's disease, syphilis, yaws, and tropical ulcers can also present with periosteal reactions and new bone formation in characteristic patterns.

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83 solid pancreatic masses on computed tomography

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1. 16Periarticular Calcification

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

3. • Fig B 16-1 Calcific tendinitis. Frontal view of the shoulder demonstrates amorphous calcium deposits (arrows) in the supraspinatus tendon.

4. • Fig B 16-2 Hyperparathyroidism. Dense mass of tumoral calcification in joint capsules and periarticular soft tissues of the lateral aspect of the foot in a patient with renal osteodystrophy.

5. • Fig B 16-3 Scleroderma. Clumps of calcification about the shoulder joints (arrows). Note the reticulonodular interstitial pattern at both lung bases. The surgical clips overlying the right apex are from a cervical sympathectomy for the treatment of associated Raynaud's phenomenon.

6. • Fig B 16-4 Tumoral calcinosis. (A) Supine view demonstrates a large, irregular calcific mass with some relatively lucent areas in the proximal thigh. (B) Upright view shows sedimentation in the liquid-filled cysts (arrow), with absence of sedimentation in the more amorphous gritty deposits.29

7. • Fig B 16-5 Calcinosis universalis. Dense calcific deposits in the soft tissues on the ulnar aspect of the thumb.

8. Fig B 16-6 Gout. (A) Frontal and (B) lateral views demonstrate massive deposition of calcium in a long-standing tophaceous lesion about the elbow.

9. • Fig B 16-7 Myositis ossificans. Marked heterotopic bone formation about the hip joint in a patient with paralysis.

10. Fig B 16-8 Pellegrini-Stieda disease. Post-traumatic ossification (arrows) along the femoral condyle.

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