Acute calcific periarthritis (hand)

Case contributed by Maulik S Patel
Diagnosis certain

Presentation

Presented with a history of swelling adjacent to the left-hand index finger MCP joint for about 4 weeks. There is an acute onset of local pain for the last 2 days. There was no history of trauma. On examination, there was local swelling, redness, and tenderness. The movement of the index finger MCP joint was painful.

Patient Data

Age: 70 years
Gender: Female

There is periarticular soft tissue calcification near dorsal-radial side of the index finger metacarpophalangeal joint. Osteopenia is present. There is no bone injury.

ultrasound

There is a well-defined periarticular soft tissue calcification involving the dorsal-radial side of the index finger metacarpophalangeal joint. It measures about 10 x 7 x 5 mm.  Adjacent soft tissues reveal inflammation and hypervascularity. The index finger metacarpophalangeal joint shows mild effusion.

Case Discussion

An elderly lady presented with an acutely painful index finger metacarpophalangeal joint. There was no associated trauma/fever. Radiographs show juxta-articular soft-tissue calcification. Ultrasound shows local inflammation due to a leak from calcium deposit. History, radiographs, and ultrasound favor acute calcific periarthritis.

The patient responded to the conservative treatment.

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