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.
The flexor carpi radialis tendon shows normal echo pattern without tenosynovitis. There is no wrist joint effusion. There is no cortical erosion in the adjacent radius and scaphoid.
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.
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