ARRS 2022 Abstracts


E1362. Soft Tissue Calcification: Metabolic, Post-traumatic, or Arthritic?
  1. Saagar Patel; UTHealth Houston McGovern Medical School
  2. Ahmed Taher; UTHealth Houston McGovern Medical School
  3. Manickam Kumaravel ; UTHealth Houston McGovern Medical School
Calcifications on radiographs and other imaging modalities can be due to a myriad of secondary causes. Often, these are incidental findings that can mimic a more concerning pathology. Understanding the cause of this aberrant process and the associated clinical significance can prevent undue stress and unnecessary workup for patients. Calcifications can vary based on location and characteristics; it can be challenging to differentiate systemic calcinosis versus calcium deposition or degeneration. Calcification can also mimic other pathologies such as calcific tendinitis, avulsions, or heterotopic ossification. Narrowing this differential and working through a quick algorithm efficiently can help manage resources and time, especially in the ER's fast-paced setting. The purpose of this educational poster is to review the various types of calcifications seen on radiographs and their respective imaging findings.

Educational Goals / Teaching Points
This presentation aims to identify the various manifestations of calcifications in the soft tissue of the extremities; understand the pathophysiology of the causation of calcifications due to metabolic, traumatic arthritic causes, and many more; and recognize the clinical implications of soft tissues calcifications in the ER setting. The exhibit provides a generalized review to avoid pitfalls in common radiographic findings.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
The pathophysiology we will discuss will include metabolic abnormalities that lead to calcification, such as gout or seronegative disorders, long-term sequelae from traumatic injuries, systemic disease processes, and many more. In addition, this review will explore the characteristics of calcifications on imaging, including structural patterns (crystalline, linear, amorphous, etc.) and locational preferences (tendinopathy, articular, soft tissue, etc.) in the setting of various clinical backgrounds.

Although calcifications are among the most common findings on extremity imaging, they can be difficult to interpret accurately. Subtle characteristics such as pattern, clinical history features, and location can assist with accurate interpretation and guide the clinician along the appropriate treatment pathway. During this review, we will explore a diagnostic path that can help radiologists and other clinicians quickly and easily interpret varying forms of calcifications. Understanding the pathophysiology and manifestations of metabolic, traumatic, and sclerotic disease is crucial for timely and efficient diagnosis.