Acute calcific periarthritis

Acute calcific periarthritis is an acutely painful monoarticular condition characterised by the juxta-articular deposition of calcium hydroxyapatite crystals and local inflammation. 

Affects both males and females over a wide age range, however, occurs more frequently in females than males between the ages of 40 to 70 years.

  • sudden onset of severe pain and swelling around one joint, usually of finger or toe
  • no history of acute trauma
  • no fever, systemic complaints or arthralgia of other joints

Acute juxta-articular soft tissue deposition of calcium hydroxyapatite crystals leading to an acute inflammatory response.

ACP is thought to represent a clinical subset of hydroxyapatite deposition disease (HADD) and occurs when crystals are acutely deposited in the periarticular capsular structures:

Well-circumscribed ovoid or curvilinear calcification adjacent to a joint (usually on one side).

  • curvilinear/ovoid calcification with acoustic shadowing
  • capsular soft tissue swelling
  • periarticular calcification
  • generally low signal from calcification
  • high signal on fluid weighted sequences from soft tissue oedema

Other causes of soft tissue calcification such as:

  • acute calcific periarthritis should be considered when faced with an acutely painful finger, especially in the presence of periarticular calcification on radiographs or ultrasound.
  • recognising the clinical presentation with correlation of imaging would avoid unnecessary treatments such as antibiotics or surgery
  • managed conservatively with nonsteroidal anti-inflammatory drugs
  • may require corticosteroid injection
  • usually responds to treatment within a week with resolution of the acute symptoms
  • periarticular calcification significantly decreases in 3-to-4 weeks but takes  longer to clear, typically 6-to-8 weeks
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Article information

rID: 64579
Synonyms or Alternate Spellings:
  • Acute calcific periarthritis (ACP)

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Cases and figures

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    Case 1: acute calcific periarthritis
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    Case 2: acute Calcific Periarthritis
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    Case 3: acute calcific periarthiritis of the knee MCL
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