- Tumoral calcinosis is a condition characterized by the development of painless, periarticular masses.
- The term should be strictly used to refer to a disease caused by a hereditary metabolic dysfunction of phosphate regulation
- Can be idiopathic or develop in association with a spectrum of conditions, including chronic renal failure, hyperparathyroidism, and collagen vascular disorders
- Pathophysiology is related to dystrophic calcification of periarticular soft tissues: calcium hydroxyapatite crystal deposition with infiltration of surrounding tissue by giant cells and histiocytes
- Typical locations: large joint, spine is uncommon
- Most common presentation: painless joint enlargement.
In spine; back pain can occur; enlarging calcinosis can cause nerve compression and radiculopathy.
- Main radiographic features:
– Appears as a calcified mass surrounding a joint.. Can cause adjacent osseous remodeling, but should not demonstrate destructive changes.
– MRI: hypointense lobulated lesions in T1 and T2
- Treatment: usually conservative with pain management and low calcium,low phosphate diet
– Surgery can be done if neurologic dysfunction, but tends to recur (since the underlying mechanism is not addressed).