Cervical paraspinal calcification in collagen vascular diseases

Area of Science:

• Rheumatology
• Orthopedics
• Radiology

Background:

• Soft-tissue calcification is frequent in collagen vascular diseases.
• Paraspinal calcification in the cervical spine is not previously described.
• Collagen vascular diseases encompass a group of autoimmune disorders affecting connective tissues.

Purpose of the Study:

• To describe a novel presentation of cervical paraspinal calcification in patients with collagen vascular disease.
• To characterize the clinical and imaging features of these calcifications.
• To differentiate these findings from other spinal pathologies.

Main Methods:

• Retrospective review of five female patients with collagen vascular disease and cervical paraspinal calcifications.
• Clinical assessment including symptoms of radiculopathy, pain, and stiffness.
• Imaging studies (e.g., X-ray, CT, MRI) to evaluate calcific masses and associated spinal changes.
• Biopsy in two patients to confirm crystal composition.

Main Results:

• Five women with collagen vascular disease presented with large, lobulated, homogeneous calcific masses in the cervical paraspinal region.
• These masses were centered on synovial articulations.
• Associated findings included osteolysis or erosions of the vertebrae.
• All patients experienced symptoms like radiculopathy, focal pain, or stiffness.
• Biopsy confirmed hydroxyapatite crystals in two cases.
• The calcifications mimicked tumoral calcinosis.

Conclusions:

• Cervical paraspinal calcification is a newly identified manifestation in collagen vascular disease.
• These symptomatic calcifications present as large soft-tissue masses.
• The condition can be mistaken for tumoral calcinosis, highlighting the need for careful diagnosis.