Acute calcific periarthritis - wrist

Case contributed by Maulik S Patel
Diagnosis almost certain

Presentation

A patient presented with acute onset of the right wrist pain for the last few days. There is no history of fever/ trauma. Local examination revealed localized swelling and tenderness on the dorsum of the wrist.

Patient Data

Age: 45 years
Gender: Female
ultrasound

At the site of swelling and pain pointed by the patient, there is an amorphous calcific deposit in the soft tissue involving the dorsum of the wrist. The calcification is located between tendons of 2nd extensor compartment and superficial to the carpal bone. There is a local hypervascularity. The extensor compartment tendons show normal echo pattern without tenosynovitis. The adjacent bone cortex does not show erosion.

Case Discussion

The case shows the typical history and ultrasound findings of acute calcific periarthritis.

Acute calcific periarthritis is an acutely painful, inflammatory, self-limiting, monoarticular condition resulting from calcium deposition in the periarticular region. The patients present with acute onset of monoarticular pain without a history of trauma/ fever. The treatment is conservative with non-steroidal anti-inflammatory drugs.

The case shows two ultrasound artifacts; acoustic shadowing and anisotropy.

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