Calcific Periarthritis-Plain Film

An adult female with  sudden onset juxta articular pain near the MCP joint of digit  with no history of trauma. X ray shows subtle soft  homogenous and amorphous calcification in the juxta articular location with no significant periarticular demineralization, Soft tissue swelling or widening of the  joint, typically favoring  acute calcific  periarthritis. MRI helps by showing abnormal soft tissue with foci of low signal corresponding to the calcification and  exclusion of the differential diagnosis

Teaching points by Dr MGK Murthy. Edited by Dr Sumer Sethi.

Acute calcific periarthritis  is a form of hydroxyapatite  deposition disease   with soft amorphous calcification localized to the site of clinical pain particularly in pre and perimenopausal women

·         D/D includes Heterotopic calcification/accessory ossicles (presence of cortex and internal trabeculation),CPPD deposits (presence of chondrocalcinosis),Gout (erosions and serum uric acid help),Metastatic  periarticular calcification like hyperparathyroidism, Endstage renal disease ,Tumoural calcinosis, and hypervitaminosis etc show multiple sites ,synovial sarcoma(presence of osteoporosis, psammamatous /peripheral calcifications, and extensive soft issue swelling) and of course pyogenic  tenosynovitis with no characteristic X ray findings.