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Calciphylaxis

Case contributed by Eugen Lungu
Diagnosis almost certain

Presentation

Left anterior hip ulcer with possible underlying calcifications at visual inspection. Under dialysis for end-stage renal disease.

Patient Data

Age: 65 years
Gender: Female
x-ray

Diffuse fine calcifications in the soft tissues of the groin and hip area with more marked reticular infiltration anteriorly, probably representing the area of the ulcer. Extensive vascular calcifications. 

No fracture or dislocation. No osseous lesion.

Total hip arthroplasty prosthesis shows normal alignment and no associated complications. 

Foley catheter.

Case Discussion

This is a case of calciphylaxis, a relatively rare cause of soft-tissue calcification usually associated with end-stage renal disease. Note the fine, circumferential vascular calcifications corresponding to medial artery calcification (Mönckeberg's arteriosclerosis) associated with disorders of calcium metabolism, as opposed to the more coarse, eccentric calcifications seen with the intimal artery calcifications of atherosclerosis

The diffuse soft-tissue calcifications were significantly less extensive on a film 8 months prior (not shown). This deterioration coincided with the patient's worsening in renal function.

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