Tumoral calcinosis

  • juxta articular calcified soft tissue masses
  • normal serum calcium and phosphorus
  • no renal, metabolic or collagen vascular disease
  • autosomal dominant
  • abnormal phosphate reabsorption
  • 1st-2nd decade
  • M=F
  • blacks
clinical
  • progressive soft tissue mass with skin ulceration, sinus tract draining chalky milk like fluid
  • swelling
  • restricted motion
  • hyperphosphatemia
  • hypervitaminosis D
  • normal serum calcium, ALP, renal function, parathyroid
  • recurs after excision
imaging
  • hip > elbow > shoulder > feet > ribs
  • never seen in knees
  • extensor surface of joints
  • dense, loculated, multiglobular calcified soft tissue mass
  • up to 20 cm size
  • cystic appearance with radiolucent septa
  • sedimentation sign – fluid fluid levels with milk of calcium
  • normal bones