SOFT TISSUE CALCIFICATION
These are listed below in order of prevalence.
(Note: Do not confuse soft tissue calcification with bone calcification. Bone calcification will be dealt in Bone Tumour Radiology)
Types of soft tissue calcification
2. Metastatic Calcification
3. Calcinosis
4. Chondrocalcinosis
5. Synovial Chondromatosis.
Dystrophic calcification
Not associated with metabolic disorder.
Almost every calcification that one sees in the soft tissues in actual radiographic practice is due to dystrophic calcification.
They have a prevalence of 95-98% out of all soft tissue calcification.
Differential diagnosis of dystrophic calcification
V = Venous - Phlebolith
I = Infection - Cysticercosis
N = Neoplasm - Osteosarcoma
D = Drugs - Vitamin D overdose
A = Autoimmune - Dermatomyositis
T = Trauma - Hematoma, Heterotopic ossification

Vascular calcification - Phlebolith in the pelvic vein with characteristic central lucency

Cysticercosis - Patient with multiple "rice grain" calcifications which are oriented along the direction of the muscle fibers.

A child with conventional intramedullary osteosarcoma of distal femur.

Hypervitaminosis D - Calcification over the elbow

Dermatomyositis-46 year old female with dermatomyositis and extensive soft tissue calcifications about the knee and hip.

Calcified hematoma - an example of dystrophic calcification

Dystrophic calcification of Achilles tendon due to recurrent trauma and tendinitis.

Heterotopic ossification of the right hip in a patient who sustained head injury
Metastatic Calcification
Frequently associated with a metabolic disorder.
Can result from any process with an elevated calcium-phosphate product.
Entities such as renal failure, hyperparathyroidism, sarcoidosis, milk-alkali syndrome, etc. can lead to metastatic calcifications.
These are often fine and diffuse throughout the soft tissues.

Metastatic calcification of the lung secondary to chronic renal disease and hyperparathyroidism.
Calcinosis
Not associated with metabolic disturbance.
May be associated with with collagen-vascular disease.
3 Types:
1. Calcinosis circumscripta
2. Calcinosis universalis
3. Tumoral calcinosis

Calcinosis circumscripta (localized deposition of calcium in small in subcutaneous tissue) in Scleroderma
Calcinosis universalis - Diffuse cutaneous, subcutaneous and sometimes muscular calcification seen in dermatomyositis
Tumoral Calcinosis
The etiology is uncertain.
The histologic appearance is characterized by densely loculated masses of calcific debris and fluid enclosed by fibrous tissue.
Lesions grow quite slowly and rarely cause pain unless there is nerve involvement.
Surgical removal is the treatment of choice.
Incomplete resection leads to recurrence.

Tumoral calcinosis in a 59 year old black woman who presented with hip pain

Elderly female with tumoral calcinosis of the hand and wrist.

Same elderly female with tumoral calcinosis of both hip joint.
Chondrocalcinosis
This typically appears as a fine white line overlying the hyaline articular cartilage.
CPPD is also associated with calcifications in the soft tissues of the spine.

Chondrocalcinosis of the articular and fibrocartilage of the left knee in a patient with calcium pyrophosphate dihydrate deposit
Synovial chondromatosis
Tends to be mono-articular.
Due to metaplasia of synovial connective tissue.
Uncommon cause of loose bodies.
Biopsy shows active synovial proliferation.

Synovial osteochondromatosis in a 24-year-old man with hip pain. Radiograph shows multiple small, dense, punctate calcifications

Synovial chondromatosis of shoulder
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Jessica
Dec 15, 2011 @ 1:55 pm | delete
- Great lense! indeed very helpful and informative which can help me a lot. Thanks
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pinnacle metal toxicity
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Gregory
Nov 11, 2011 @ 3:54 pm | delete
- Thank you for this blog. It is good for us not be emotional.
DePuy Pinnacle Hip Replacement
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John
Oct 28, 2011 @ 12:14 pm | delete
- These diseases are so horrible.I'm not an X-Ray expert but I can clearly see that this is way not normal. Are these soft tissue calcification diseases curable?
Hip Replacement Recall
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johndavid12
Aug 19, 2011 @ 1:28 pm | delete
- Great lens, and the video is very vivid too. On the other hand, Fosamax was guilty in causing a thigh bone fracture to some of its long-term users. Many affected individulas have considered filing a Fosamax Lawsuit against Merck.
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depuyhipreplace7
Jul 29, 2011 @ 10:44 am | delete
- This is a great lens, ever since I heard of the Hip Replacement Recall I went over my old hip x-rays and now know what I've been looking at,
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