Presentation
Presented with a history of the left wrist recurrent pain for the last few months. There was no associated trauma/fever. On examination, there was tenderness involving the dorsoradial side of the wrist.
Patient Data
There is soft tissue calcification (4 x 3 mm) on the radial side of the flexor carpi radialis tendon and scaphoid. There is perifocal echogenic fat and hypervascularity.
Case Discussion
A young male presented with a history of the non-traumatic recurrent wrist pain. Ultrasound shows amorphous calcification at the site of pain. The calcification is close to the flexor carpi radials tendon which shows normal echo pattern. There is a perifocal hypervascularity. Ultrasound findings favor acute calcific periarthritis of the wrist.
Acute calcific periarthritis is a self-limiting, monoarticular, periarticular inflammatory process resulting from juxta-articular deposits of amorphous calcium hydroxyapatite.
The patient usually presents with acute onset of localized pain involving a joint without trauma/fever.
Differentials include infection, tendon-related HADD, gout, CPPD. The treatment is conservative with non-steroidal anti-inflammatory drugs.