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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.
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