Korean Journal of Radiology

The Korean Society of Radiology (대한영상의학회)
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Imaging Features of Soft-Tissue Calcifications and Related Diseases: A Systematic Approach

  • Hwang, Zhen-An (Department of Radiology, Wan Fang Hospital, Taipei Medical University) ;
  • Suh, Kyung Jin (Department of Radiology, Dongguk University Gyeongju Hospital) ;
  • Chen, Dillon (Department of Radiology, University of California) ;
  • Chan, Wing P. (Department of Radiology, Wan Fang Hospital, Taipei Medical University) ;
  • Wu, Jim S. (Department of Radiology, Beth Israel Deaconess Medical Center)
  • Received : 2017.10.23
  • Accepted : 2018.05.08
  • Published : 2018.12.01
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Abstract

Soft-tissue calcification refers to a broad category of lesions. Calcifications are frequently identified by radiologists in daily practice. Using a simple algorithm based on the distribution pattern of the lesions and detailed clinical information, these calcified lesions can be systematically evaluated. The distribution pattern of the calcific deposits enables initial division into calcinosis circumscripta and calcinosis universalis. Using laboratory test results (serum calcium and phosphate levels) and clinical history, calcinosis circumscripta can be further categorized into four subtypes: dystrophic, iatrogenic, metastatic, and idiopathic calcification. This pictorial essay presents a systematic approach to the imaging features of soft-tissue calcifications and related diseases.

Keywords

References

  1. Santili C, Akkari M, Waisberg G, Kessler C, Alcantara Td, Delai PL. Calcinosis universalis: a rare diagnosis. J Pediatr Orthop B 2005;14:294-298 https://doi.org/10.1097/01202412-200507000-00012
  2. Abdallah-Lotf M, Grasland A, Vinceneux P, Sigal-Grinberg M. Regression of cutis calcinosis with diltiazem in adult dermatomyositis. Eur J Dermatol 2005;15:102-104
  3. Olsen KM, Chew FS. Tumoral calcinosis: pearls, polemics, and alternative possibilities. Radiographics 2006;26:871-885 https://doi.org/10.1148/rg.263055099
  4. Chander S, Gordon P. Soft tissue and subcutaneous calcification in connective tissue diseases. Curr Opin Rheumatol 2012;24:158-164 https://doi.org/10.1097/BOR.0b013e32834ff5cd
  5. Stewart VL, Herling P, Dalinka MK. Calcification in soft tissues. JAMA 1983;250:78-81 https://doi.org/10.1001/jama.1983.03340010060032
  6. Lafferty FW, Reynolds ES, Pearson OH. Tumoral calcinosis: a metabolic disease of obscure etiology. Am J Med 1965;38:105-118 https://doi.org/10.1016/0002-9343(65)90164-6
  7. Tokoro S, Satoh T, Okubo Y, Igawa K, Yokozeki H. Latent dystrophic subcutaneous calcification in patients with chronic venous insufficiency. Acta Derm Venereol 2009;89:505-508 https://doi.org/10.2340/00015555-0680
  8. Rana RS, Wu JS, Eisenberg RL. Periosteal reaction. AJR Am J Roentgenol 2009;193:W259-W272 https://doi.org/10.2214/AJR.09.3300
  9. Kim H, Greenberg JS, Javitt MC. Breast calcifications due to Monckeberg medial calcific sclerosis. Radiographics 1999;19:1401-1403 https://doi.org/10.1148/radiographics.19.5.g99se221401
  10. Tahmasbi-Arashlow M, Barghan S, Kashtwari D, Nair MK. Radiographic manifestations of Monckeberg arteriosclerosis in the head and neck region. Imaging Sci Dent 2016;46:53-56 https://doi.org/10.5624/isd.2016.46.1.53
  11. Flors L, Leiva-Salinas C, Maged IM, Norton PT, Matsumoto AH, Angle JF, et al. MR imaging of soft-tissue vascular malformations: diagnosis, classification, and therapy followup. Radiographics 2011;31:1321-1340; discussion 1340-1341 https://doi.org/10.1148/rg.315105213
  12. Fayad LM, Hazirolan T, Bluemke D, Mitchell S. Vascular malformations in the extremities: emphasis on MR imaging features that guide treatment options. Skeletal Radiol 2006;35:127-137 https://doi.org/10.1007/s00256-005-0057-1
  13. Ernemann U, Kramer U, Miller S, Bisdas S, Rebmann H, Breuninger H, et al. Current concepts in the classification, diagnosis and treatment of vascular anomalies. Eur J Radiol 2010;75:2-11 https://doi.org/10.1016/j.ejrad.2010.04.009
  14. Steinbach LS, Resnick D. Calcium pyrophosphate dihydrate crystal deposition disease revisited. Radiology 1996;200:1-9 https://doi.org/10.1148/radiology.200.1.8657894
  15. Ogata M. [A clinical study of calcium pyrophosphate dihydrate crystal deposition disease]. Nihon Seikeigeka Gakkai Zasshi 1985;59:819-834
  16. Jacobson JA, Girish G, Jiang Y, Sabb BJ. Radiographic evaluation of arthritis: degenerative joint disease and variations. Radiology 2008;248:737-747 https://doi.org/10.1148/radiol.2483062112
  17. Westall J. Tuberculosis levelling off worldwide. BMJ 1997;314:921
  18. De Backer AI, Vanhoenacker FM, Sanghvi DA. Imaging features of extraaxial musculoskeletal tuberculosis. Indian J Radiol Imaging 2009;19:176-186 https://doi.org/10.4103/0971-3026.54873
  19. Hugosson C, Nyman RS, Brismar J, Larsson SG, Lindahl S, Lundstedt C. Imaging of tuberculosis. V. Peripheral osteoarticular and soft-tissue tuberculosis. Acta Radiol 1996;37:512-516 https://doi.org/10.1177/02841851960373P216
  20. Jaovisidha S, Chen C, Ryu KN, Siriwongpairat P, Pekanan P, Sartoris DJ, et al. Tuberculous tenosynovitis and bursitis: imaging findings in 21 cases. Radiology 1996;201:507-513 https://doi.org/10.1148/radiology.201.2.8888250
  21. Meyerding HW, Mroz RJ. Tuberculosis of the greater trochanter. JAMA 1933;101:1308-1313 https://doi.org/10.1001/jama.1933.02740420028008
  22. Rehm-Graves S, Weinstein AJ, Calabrese LH, Cook SA, Boumphrey FR. Tuberculosis of the greater trochanteric bursa. Arthritis Rheum 1983;26:77-81 https://doi.org/10.1002/art.1780260112
  23. Murphey MD, Gibson MS, Jennings BT, Crespo-Rodriguez AM, Fanburg-Smith J, Gajewski DA. From the archives of the AFIP: imaging of synovial sarcoma with radiologic-pathologic correlation. Radiographics 2006;26:1543-1565 https://doi.org/10.1148/rg.265065084
  24. Jones BC, Sundaram M, Kransdorf MJ. Synovial sarcoma: MR imaging findings in 34 patients. AJR Am J Roentgenol 1993;161:827-830 https://doi.org/10.2214/ajr.161.4.8396848
  25. Kransdorf MJ, Meis JM. From the archives of the AFIP. Extraskeletal osseous and cartilaginous tumors of the extremities. Radiographics 1993;13:853-884 https://doi.org/10.1148/radiographics.13.4.8356273
  26. Nuovo MA, Norman A, Chumas J, Ackerman LV. Myositis ossificans with atypical clinical, radiographic, or pathologic findings: a review of 23 cases. Skeletal Radiol 1992;21:87-101
  27. Bhalla A, Sood A, Sachdev A, Varma V. Disseminated cysticercosis: a case report and review of the literature. J Med Case Rep 2008;2:137 https://doi.org/10.1186/1752-1947-2-137
  28. Roche CJ, O'Keeffe DP, Lee WK, Duddalwar VA, Torreggiani WC, Curtis JM. Selections from the buffet of food signs in radiology. Radiographics 2002;22:1369-1384 https://doi.org/10.1148/rg.226025521
  29. Naik D, Srinath M, Kumar A. Soft tissue cysticercosis - Ultrasonographic spectrum of the disease. Indian J Radiol Imaging 2011;21:60-62 https://doi.org/10.4103/0971-3026.76059
  30. Narvaez JA, Narvaez J, Ortega R, Aguilera C, Sanchez A, Andia E. Painful heel: MR imaging findings. Radiographics 2000;20:333-352 https://doi.org/10.1148/radiographics.20.2.g00mc09333
  31. Richards PJ, Braid JC, Carmont MR, Maffulli N. Achilles tendon ossification: pathology, imaging and aetiology. Disabil Rehabil 2008;30:1651-1665 https://doi.org/10.1080/09638280701785866
  32. Morris KL, Giacopelli JA, Granoff D. Classifications of radiopaque lesions of the tendo Achillis. J Foot Surg 1990;29:533-542
  33. Speed CA, Hazleman BL. Calcific tendinitis of the shoulder. N Engl J Med 1999;340:1582-1584 https://doi.org/10.1056/NEJM199905203402011
  34. Serafini G, Sconfienza LM, Lacelli F, Silvestri E, Aliprandi A, Sardanelli F. Rotator cuff calcific tendonitis: short-term and 10-year outcomes after two-needle us-guided percutaneous treatment--nonrandomized controlled trial. Radiology 2009;252:157-164 https://doi.org/10.1148/radiol.2521081816
  35. ViGario GD, Keats TE. Localization of calcific deposits in the shoulder. Am J Roentgenol Radium Ther Nucl Med 1970;108:806-811 https://doi.org/10.2214/ajr.108.4.806
  36. Mendes LF, Pretterklieber ML, Cho JH, Garcia GM, Resnick DL, Chung CB. Pellegrini-Stieda disease: a heterogeneous disorder not synonymous with ossification/calcification of the tibial collateral ligament-anatomic and imaging investigation. Skeletal Radiol 2006;35:916-922 https://doi.org/10.1007/s00256-006-0174-5
  37. Cockshott WP, Thompson GT, Howlett LJ, Seeley ET. Intramuscular or intralipomatous injections? N Engl J Med 1982;307:356-358 https://doi.org/10.1056/NEJM198208053070607
  38. Prosch H, Mirzaei S, Oschatz E, Strasser G, Huber M, Mostbeck G. Case report: gluteal injection site granulomas: false positive finding on FDG-PET in patients with non-small cell lung cancer. Br J Radiol 2005;78:758-761 https://doi.org/10.1259/bjr/55106848
  39. Stein L, Elsayes KM, Wagner-Bartak N. Subcutaneous abdominal wall masses: radiological reasoning. AJR Am J Roentgenol 2012;198:W146-W151 https://doi.org/10.2214/AJR.10.7238
  40. Degrassi F, Quaia E, Martingano P, Cavallaro M, Cova MA. Imaging of haemodialysis: renal and extrarenal findings. Insights Imaging 2015;6:309-321 https://doi.org/10.1007/s13244-015-0383-3
  41. Gordon LF, Arger PH, Dalinka MK, Coleman BG. Computed tomography in soft tissue calcification layering. J Comput Assist Tomogr 1984;8:71-73 https://doi.org/10.1097/00004728-198402000-00015
  42. Chang CY, Rosenthal DI, Mitchell DM, Handa A, Kattapuram SV, Huang AJ. Imaging findings of metabolic bone disease. Radiographics 2016;36:1871-1887 https://doi.org/10.1148/rg.2016160004
  43. Khan AA, Hanley DA, Rizzoli R, Bollerslev J, Young JE, Rejnmark L, et al. Primary hyperparathyroidism: review and recommendations on evaluation, diagnosis, and management. A Canadian and international consensus. Osteoporos Int 2017;28:1-19
  44. Khan A, Bilezikian J. Primary hyperparathyroidism: pathophysiology and impact on bone. CMAJ 2000;163:184-187
  45. Wilson LC, Hall CM. Albright's hereditary osteodystrophy and pseudohypoparathyroidism. Semin Musculoskelet Radiol 2002;6:273-283 https://doi.org/10.1055/s-2002-36726
  46. Mantovani G. Clinical review: pseudohypoparathyroidism: diagnosis and treatment. J Clin Endocrinol Metab 2011;96:3020-3030 https://doi.org/10.1210/jc.2011-1048
  47. Moore SL, Teirstein AE. Musculoskeletal sarcoidosis: spectrum of appearances at MR imaging. Radiographics 2003;23:1389-1399 https://doi.org/10.1148/rg.236025172
  48. James DG, Neville E, Carstairs LS. Bone and joint sarcoidosis. Semin Arthritis Rheum 1976;6:53-81 https://doi.org/10.1016/S0049-0172(76)80005-4
  49. Aptel S, Lecocq-Teixeira S, Olivier P, Regent D, Teixeira PG, Blum A. Multimodality evaluation of musculoskeletal sarcoidosis: imaging findings and literature review. Diagn Interv Imaging 2016;97:5-18 https://doi.org/10.1016/j.diii.2014.11.038
  50. Koyama T, Ueda H, Togashi K, Umeoka S, Kataoka M, Nagai S. Radiologic manifestations of sarcoidosis in various organs. Radiographics 2004;24:87-104 https://doi.org/10.1148/rg.241035076

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