Calcinosis Circumscripta

General Considerations

• Punctate calcifications resulting from the deposition of calcium hydroxyapatite crystals in the skin and subcutaneous tissues
• Most often associated with scleroderma, dermatomyositis and/or Raynaud’s phenomenon
• Occurs most often in adult females (6:1 female:male)
• Mostly in the upper extremity, especially the fingers
• One of the manifestations of CREST syndrome
• Calcinosis
• Raynaud's phenomenon
• Esophageal dysmotility
• Sclerodactyly
• Telangiectasia

Clinical Findings

• Small, localized hard masses in the fingers
• Skin may be tight, thickened with loss of normal skin folds
• Painful ulcerations at ends of digits

Imaging Findings

• Well-circumscribed calcifications in the soft tissues, frequently peri-articular
• Hands may also demonstrate resorption of the terminal phalanges (acro-osteolysis)
• Soft tissue atrophy of the tufts (sclerodactyly)

Differential Diagnosis

• Tophaceous gout
• Chronic renal disease
• Idiopathic tumoral calcinosis
• Milk-alkali syndrome
• Hypervitaminosis D

Calcinosis Circumscripta in Scleroderma. Radiographs of both hands show multiple, punctate calcifications (circles) in the soft tissues of both hands characteristic of calcinosis circumscripta. The patient had a 12 year history of scleroderma.
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JH Klippel, LJ Crofford, JH Stone, CM Weyand. Primer on the Rheumatic Diseases12th Edition 2001; 353-367.