Soft tissue calcifications (hip)

Case contributed by Dr. Dana M DeCarlo

Presentation

Presenting after ground-level fall with left hip pain.

Patient Data

Age: 75 years
Gender: Female
X-ray

Innumerable rounded calcifications of varying sizes measuring up to 1 cm are seen in the soft tissues around both hips/the buttocks, most consistent with phleboliths.  No discrete mass is evident.  Few calcifications were seen extending into the soft tissues of the distal left thigh.

The alignment and bone density is normal considering technique for her age.
Mild degenerative changes are noted in both hips.

Case Discussion

The differential diagnosis for soft-tissue calcifications on x-ray are:

  • phleboliths
  • calcinosis cutis
  • calcific uremic arteriolopathy (calciphylaxis)
  • panniculitis
  • milia
  • injection granulomas
  • tumoral calcinosis
  • atherosclerotic vascular calcifications

This patient had a normal creatinine, making calciphylaxis lower on the differential.  She did not have a history of intramuscular or subcutaneous medication use, though cosmetic injections cannot be ruled out. The patient's medical history and radiographic findings are most consistent with phleboliths.

This case was submitted with supervision and input from:

Soni C. Chawla, M.D.
Associate Professor
Department of Radiological Sciences
David Geffen School of Medicine at UCLA
Olive View - UCLA Medical Center   

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Case information

rID: 55451
Case created: 6th Sep 2017
Last edited: 8th Sep 2017
Inclusion in quiz mode: Excluded
Institution: Olive View - UCLA Medical Center

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