Calcinosis of Chronic Renal Disease
Secondary Tumoral Calcinosis

General Considerations

• Also called uremic tumoral calcinosis and sometimes secondary tumoral calcinosis
• Calcified masses are uncommon overall with a frequency range between 0.5% and 3% in renal patients, but the most frequent cause of a calcified periarticular “mass” is chronic renal failure
• Occurs more commonly in patients on hemodialysis for greater than 3 years
• No histologic or radiologic differences between this type of calcinosis and the lesions of primary tumoral calcinosis

Clinical Findings

• Most frequently occurs in the context of hyperparathyroidism

Imaging Findings

• Amorphous and/or multi-lobulated calcification located in a periarticular distribution
• Joint space is preserved
• Underlying bone and muscle are not usually involved
• CT shows no erosion or adjacent destruction of bone
• MRI shows inhomogeneous high-signal intensity on T2-weighted sequences  while T1-weighted sequences usually show inhomogeneous lesions with low signal intensity  

 
Calcinosis of Chronic Renal Failure. A smoothly marginated, very dense and multilobulated calcified mass is seen adjacent to the right knee joint (white arrows). There is also diffuse soft tissue calcification present (red arrows.

Tumoral Calcinosis: Pearls, Polemics and Alternative Possibilities. KM Olsen and FS Chew. RadioGraphics. May-June, 2006, Vol. 26, 3.