Soft Tissue Calcifications
Robert B. Carr, MD
DIFFERENTIAL DIAGNOSIS
Common
Dystrophic Calcification
Less Common
Metastatic Calcification
Chondrocalcinosis
Rare but Important
Tumoral Calcinosis
Neoplasm
ESSENTIAL INFORMATION
Key Differential Diagnosis Issues
Includes skin, subcutaneous fat, muscle, and connective tissues; not mediastinum
Calcification refers to calcium deposition without specific structural organization
Ossification refers to calcium deposition with formation of medullary space and cortex
It is not always possible to distinguish between calcification and ossification
Clinical history usually important in establishing diagnosis
Helpful Clues for Common Diagnoses
Dystrophic Calcification
Accounts for approximately 95% of soft tissue calcification
Underlying inflammatory disorder, not metabolic disease
Commonly from trauma or infection; may progress to heterotopic ossification
Also connective tissue disorders, such as scleroderma, SLE, dermatomyositis
Usually amorphous in appearance; can be focal or quite extensive
Helpful Clues for Less Common Diagnoses
Metastatic Calcification
Associated with systemic metabolic disease, chronic renal failure, hypercalcemia
Can appear speckled or large and globular
Associated with calcification of other structures, including vessels and heart valves
Chondrocalcinosis
Dystrophic calcification of cartilage, often due to calcium pyrophosphate dihydrate deposition disease (CPPD)
Seen in shoulder joint and intervertebral discs
Helpful Clues for Rare Diagnoses
Tumoral Calcinosis
Rare familial condition
Large, round or amorphous, periarticular calcifications; dependent sedimentation levels may be present
Shoulder joint is commonly affected
Neoplasm
Primary bone neoplasm may invade soft tissues
Consider osteosarcoma, chondrosarcoma, hemangiomas
Distant metastases to soft tissues are very rare
Stay updated, free articles. Join our Telegram channel
Full access? Get Clinical Tree
