Skip to main content

Advertisement

Log in

Acute calcific periarthritis of the hand and wrist: a series and review of the literature

  • Review Article
  • Published:
Emergency Radiology Aims and scope Submit manuscript

Abstract

This article presents three patients with acute calcific periarthritis (ACP) of the hand and wrist. ACP is an unusual, painful, monoarticular, periarticular inflammatory process associated with juxtaarticular deposits of amorphous calcium hydroxyapatite. ACP is a distinct clinical subset of hydroxyapatite deposition disease. ACP has a high rate of misdiagnosis because of its rare occurrence and its clinical resemblance to other entities. Clinical presentation may simulate infection, and the associated periarticular calcifications may be mistaken for gout, pseudogout, or other entities. One third of patients with ACP provide a history of antecedent trauma. Treatment is conservative. Patients typically will have a reduction in symptoms within 4–7 days after the acute onset of pain. Radiographically, the periarticular mineralization usually resolves or markedly decreases within 2–3 weeks, although on occasion, some calcifications may remain visible for months. Failure to recognize and correlate the typical clinical and radiographic presentation of this disease may lead to unnecessary diagnostic tests, invasive procedures, and inappropriate medication.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Hitchcock ER, Langton L (1959) Peritendinitis calcarea with special reference to the hand. J Fac Radiol 10:86

    Article  Google Scholar 

  2. Moyer RA, Bush DC, Harrington TM (1989) Acute calcific tendinitis of the hand and wrist: a report of 12 cases and a review of the literature. J Rheumatol 16:198–202

    PubMed  CAS  Google Scholar 

  3. Pollen AG (1961) Calcaerous deposits about the metacarpophalangeal joints. J Bone Jt Surg 43B(2):250–255

    Google Scholar 

  4. Selby CL (1984) Acute calcific tendinitis of the hand: an infrequently recognized and frequently misdiagnosed form of periarthritis. Arthritis Rheum 27:337–340

    Article  PubMed  CAS  Google Scholar 

  5. Yosipovitch G, Yosipovitch Z (1993) Acute calcific periarthritis of the hand and elbows in women. A study and review of the literature. J Rheumatol 20:1533–1538

    PubMed  CAS  Google Scholar 

  6. Fam AG, Pritzker KP, Stein JL, Houpt JB, Little AH (1979) Apatite-associated arthropathy: a clinical study of 14 cases and of 2 patients with calcific bursitis. J Rheumatol 6:461–471

    PubMed  CAS  Google Scholar 

  7. McCarthy GM, Carrera GF, Ryan LM (1993) Acute calcific periarthritis of the finger joints: a syndrome of women. J Rheumatol 20:1077–1080

    PubMed  CAS  Google Scholar 

  8. Hayes CW, Conway WF (1990) Calcium hydroxyapatite deposition disease. Radiographics 10(6):1031–1048

    PubMed  CAS  Google Scholar 

  9. Lee K-B, Song K-J, Kwak H-S, Lee S-Y (2004) Acute calcific periarthritis of proximal interphalangeal joints in a professional golfer’s hand. J Korean Med Sci 19:904–906

    Article  PubMed  Google Scholar 

  10. Greene TL, Louis DS (1980) Calcifying tendinitis in the hand. Ann Emerg Med 9(8):438–440

    Article  PubMed  CAS  Google Scholar 

  11. Dilley DF, Tonkin MA (1991) Acute calcific tendinitis in the hand and wrist. J Hand Surg 16B:215–216

    Google Scholar 

  12. Lee EY, Rubin DA, Brown DM (2004) Recurrent Mycobacterium marinum tenosynovitis of the wrist mimicking extraarticular synovial chondromatosis on MR images. Skelet Radiol 33(7):405–408

    Article  Google Scholar 

  13. Carroll RE, Sinton W, Garcia A (1955) Acute calcium deposits in the hand. JAMA 157:422–426

    Article  CAS  Google Scholar 

  14. Gravanis MB, Gaffney EF (1983) Idiopathic calcifying tenosynovitis. Histopathologic features and possible pathogenesis. Am J Surg Pathol 7:357–361

    Article  PubMed  CAS  Google Scholar 

  15. Metha JA, Bignold LP, Pope RO (1999) Intraarticular rupture of digital tenosynovial calcification: an unusual case of acute arthritis of the finger. J Rheumatol 26:1643–1644

    PubMed  CAS  Google Scholar 

  16. Uhthoff HK, Sarkar K, Maynard JA (1976) Calcifying tendinitis: a new concept of its pathogenesis. Clin Orthop Relat Res 118:164–168

    PubMed  Google Scholar 

  17. Chung CB, Gentili A, Chew FS (2004) Calcific tendinosis and periarthritis: classic magnetic resonance imaging appearance and associated findings. J Comput Assist Tomogr 28:390–396

    Article  PubMed  Google Scholar 

  18. Thompson GR, Ting MY, Riggs GA, Fenn ME, Denning RM (1968) Calcific tendinitis and soft-tissue calcification resembling gout. JAMA 203:464–472

    Article  PubMed  CAS  Google Scholar 

  19. Yelton CL, Dickey LE (1958) Calcification about the hand and wrist. South Med J 51:489–495

    Article  PubMed  CAS  Google Scholar 

  20. Chau CL, Griffith JF, Chan PT, Lui TH, Yu KS, Ngai WK (1996) Rice-body formation in atypical mycobacterial tenosynovitis and bursitis. Findings on sonography and MR imaging. Am J Roentgenol 180(3):1455–1459

    Google Scholar 

  21. Resnick D (1988) Calcium hydroxyapatite crystal deposition disease. Diagnosis of bone and joint disease, 2nd edn. Saunders, Philadelphia, pp 425–430

    Google Scholar 

  22. Andersen SE, Bosshard C, Steinbach LS, Ballmer FT (2003) MR imaging of calcification of the lateral collateral ligament of the knee: a rare abnormality and a cause of lateral knee pain. Am J Roentgenol 181:199–202

    Google Scholar 

  23. Hamada J, Ono W, Tamai K, Saotome K, Hoshino T (2001) Analysis of calcium deposits in calcific periarthritis. J Rheumatol 28:809–813

    PubMed  CAS  Google Scholar 

  24. Mitchell M, Howard B, Haller J, Sartoris D, Resnic D (1988) Septic arthritis. Radiol Clin North Am 26:1295–1313

    PubMed  CAS  Google Scholar 

  25. Shirtliff ME, Mader JT (2002) Acute septic arthritis. Clin Microbiol Rev 15:527–544

    Article  PubMed  Google Scholar 

  26. Shawker TH, Dennis JM (1971) Periarticular calcifications in pyogenic arthritis. Am J Roentgenol 13(4):650–654

    Google Scholar 

  27. Barenhelier JA, Morgan HC, Stamp WG (1966) Treatment and sequelae of experimentally produced septic arthritis. Surg Gynecol Obstet 122:249–254

    Google Scholar 

  28. Bonavita JA, Dalinka MK, Schumacher HR (1980) Hydroxyapatie deposition disease. Radiology 134:621–625

    PubMed  CAS  Google Scholar 

  29. Steinbach LS, Resnick D (1996) Calcium pyrophosphate dihydrate crystal deposition disease revisited. Radiology 200:1–9

    PubMed  CAS  Google Scholar 

  30. Bloch C, Hermann G, Yu TF (1980) A radiologic reevaluation of gout: a study of 2000 patients. Am J Roentgenol 134:781–787

    CAS  Google Scholar 

  31. Mirahmadi KS, Coburn JW, Blustone R (1973) Calcific periarthritis and hemodialysis. JAMA 223(5):548–549

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Paul D. Clifford.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Doumas, C., Vazirani, R.M., Clifford, P.D. et al. Acute calcific periarthritis of the hand and wrist: a series and review of the literature. Emerg Radiol 14, 199–203 (2007). https://doi.org/10.1007/s10140-007-0626-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10140-007-0626-9

Keywords

Navigation