Age / Sex : 49 / M

Chief complaint : incidentally detected Lt elbow mass

P.Hx : 
Gouty arthritis
CKD stage 5 with CAPD
Chronic Hepatitis C
Hyperparathyroidism


What is your diagnosis?

Two weeks later, you can see the final diagonosis with a brief discussion of this case (Please submit only one answer).

Courtesy : 정재영 (Jeong Jaeyeong), 전북대학교병원 (Jeonbuk national university hospital)

Calcinosis of Chronic Kidney Disease

Discussion

Findings

1.US : multiple hyperechoic mass with acoustic shadowing

1.CT : periarticular well-circumscribed and multilobular area separated from each other by thin linear radiolucent lines like a “chicken wire” pattern

1.DECT : No green color coding

Secondary tumoral calcinosis (STC) refers to periarticular calcified masses associated with an identifiable condition. The most common of these identifiable conditions is a chronic renal failure.

Radiographic findings are amorphous, cystic and lobulated (cloud-like), dense calcifications in a periarticular distribution.

CT can better delineate the masses and will typically demonstrate lack of erosion or osseous destruction, which is a classic feature of tumoral calcinosis.

• Tumoral Calcinosis:Pearls, Polemics, and Alternative Possibilities, RadioGraphics 2006;26:871–885


• Multimodality Imaging of Calcinosis of Chronic Renal Failure, Cureus. 2017 Mar; 9(3): e1113.