This site is targeted at medical and radiology professionals, contains user contributed content, and material that may be confusing to a lay audience. Use of this site implies acceptance of our Terms of Use.

Tumoral calcinosis

Tumoral calcinosis is a rare familial condition characterized by painless, peri-articular masses. The term should be strictly used to refer to a disease caused by a hereditary metabolic dysfunction of phosphate regulation associated with massive periarticular calcinosis and should not be used to refer to soft-tissue calcification in general.

The condition predominately affects young black patients with an equal male to female ratio. A third of cases are familial (autosomal dominant), and serum calcium is normal (some sources state that hyperphosphataemia is common). It is characterised by large amorphous calcific densities that surround joints. These are separated into lobules by fibrous septae and may demonstrate fluid/calcium levels (milk of calcium - hydroxyapatite crystals in suspension).

Clinical presentation

Most patients present with lumps adjacent to joints. They are usually painless, but some patients describe pain and tenderness. Involvement of large joints is typical, although the knee is rarely involved. The underlying bone is normal.

Radiographic features

Plain film

Tumoral calcinosis has a typical appearance on plain radiographs with amorphous, cystic, and multilobulated calcification located in a periarticular distribution.

CT

CT better delineates the calcific mass. There is no erosion or osseous destruction by adjacent soft-tissue masses which is another distinguishing finding of tumoral calcinosis from other pathologies.

MRI

MR imaging with T2-weighted sequences generally shows inhomogeneous high-signal intensity even though there is a large amount of calcification. T1-weighted sequences usually show inhomogeneous lesions with low signal intensity.

Differential diagnosis

General imaging differential considerations include

Updating… Please wait.
Loadinganimation

Alert_accept

Error Unable to process the form. Check for errors and try again.

Alert_accept Thank you for updating your details.