18 generalized calcification or ossification in muscles and

18 Generalized Calcification or Ossification in Muscles and

Subcutaneous Tissues

CLINICAL IMAGAGINGAN ATLAS OF DIFFERENTIAL DAIGNOSIS

EISENBERG

DR. Muhammad Bin Zulfiqar PGR-FCPS III SIMS/SHL

• Fig B 18-1 Dermatomyositis. Extensive deposits of calcium in the soft tissues about the humerus and elbow and loss of the sharp demarcation between the muscles and the subcutaneous tissues.

• Fig B 18-2 Scleroderma. Extensive calcifications about the hip joint and proximal femur.

• Fig B 18-3 Calcinosis universalis. Huge calcified mass in the subcutaneous and deep connective tissues of the lower leg.

• Fig B 18-4 Hypervitaminosis D. Diffuse calcification involving the interosseous ligament between the tibia and fibula as well as vascular structures

• Fig B 18-5 Hypervitaminosis D. Huge masses of calcification near the shoulder joints bilaterally.

• Fig B 18-6 Hypoparathyroidism. Soft-tissue calcifications lying in muscle bundles about both hip joints.

• Fig B 18-7 Arteriosclerosis of the lower extremities. There are calcified plaques (arrows) in the walls of aneurysms of the lower abdominal aorta and both common iliac arteries.

• Fig B 18-8 Mönckeberg's sclerosis. Typical calcification of the media in moderate-sized vessels of a diabetic patient. Note the prior surgical resection of the phalanges of the fourth digit.

• Fig B 18-9 Varicose veins. Multiple, round and oval calcifications in the soft tissues (phleboliths) representing calcified thrombi, some of which have characteristic lucent centers (black arrows). Extensive new bone formation along the medial aspect of the tibial shaft (white arrows) caused by long-standing vascular stasis.

• Fig B 18-10 Soft-tissue hemangiomas with phleboliths involving (A) the thumb and (B) the forearm.

• Fig B 18-11 Maffucci's syndrome. (A) Plain radiograph demonstrates multiple soft-tissue masses and calcified thrombi in association with expansile bony lesions. (B) Late film from an arteriogram shows contrast material filling many cavernous hemangiomas of the soft tissues.

• Fig B 18-12 Systemic lupus erythematosus. Lace-like calcification about the elbow.

• Fig B 18-13 Pseudoxanthoma elasticum. Extensive calcification in soft tissues on the radial side of the wrist.

• Fig B 18-14 Cysticercosis. Multiple, linear and oval calcifications along muscle bundles.

• Fig B 18-15 Myositis ossificans progressiva. Frontal view of the chest demonstrates extensive new bone formation in the soft tissues, which severely limited arm motion. Note the exostosis of the left proximal humerus due to blending of the ossific foci with the cortex of the bone.31

• Fig B 18-16 Fluorosis. Calcification of the sacrotuberous ligaments (arrows).