Massive periarticular calcinosis

Case contributed by Phillippa Gray

Presentation

Mechanical fall. Known end-stage renal failure.

Patient Data

Age: 70 years
Gender: Male
x_ray

Right subcapital neck of femur fracture.

Bilateral amorphous and multilobulated ("cloud-like") calcifications are evident surrounding both hips with some smaller calcifications surrounding bilateral inferior pubic rami.

The subcapital neck of femur fracture is again demonstrated.

There is extensive heterogeneous calcinosis surrounding the hip. The calcinosis lies primarily within the soft tissues but there is infiltration into the greater trochanter, the posterior aspect of the femur, the iliac wing and inferior pubic ramus.

Case Discussion

This patient was known to have tertiary hyperparathyroidism due to end-stage renal failure secondary to Goodpasture syndrome. 

While the pelvic radiograph may appear highly suggestive of tumoral calcinosis, the fact there is bony infiltration on CT, alongside the clinical history, distinguishes this case as calcinosis secondary to hyperparathyroidism and renal disease.

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