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Acute calcific periarthritis (elbow)

Case contributed by Maulik S Patel
Diagnosis almost certain

Presentation

Acute onset of severe pain involving the lateral side of the right elbow. No trauma.

Patient Data

Age: 25 years
Gender: Female

There are peri-articular soft tissue calcification foci on the lateral side of the right elbow. There are two dense adjacent calcifications in the superficial plane. There is a faint calcification in the deeper plane. Bones show normal trabecular pattern and cortex. There is no joint effusion.

ultrasound

There are calcification foci involving radial collateral ligament, common extensor tendon, and adjacent superficial tissue. The larger calcification shows acoustic shadowing. There is local hypervascularity in the common extensor tendon and peritendinous soft tissue. Common extensor tendon and the radial collateral ligaments are intact. There was no elbow effusion.

Case Discussion

A young female developed lateral elbow region severe pain for the last few hours. There was no history of chronic lateral elbow pain.

Radiograph and ultrasound show periarticular soft tissue calcifications. Doppler study reveals local hypervascularity. 

Given history and radiology findings, the diagnosis of acute calcific periarthritis is made. Lateral epicondylitis may show similar calcification in the common extensor tendon. However, it clinically presents as chronic lateral elbow pain.

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