Calciphylaxis: The potential diagnostic role of radiologists

Calciphylaxis is a deadly disease that is currently diagnosed through a skin biopsy of resultant necrotic lesions despite many cases lacking this characteristic finding. Recently, research has demonstrated the ability of various radiologic techniques to detect calciphylaxis and have promoted their capabilities in earlier diagnosis without tissue invasion. In this case, an obese 55-year-old female with end stage renal disease, and a long history of dialysis, complained of weeks of persistent abdominal pain that was accompanied by a mottled, lacey, net-like rash that resembled livedo reticularis. Computed tomography of the abdomen revealed extensive arterial calcification and subcutaneous calcium deposition. These radiologic findings, coupled to a high clinical suspicion, prompted treatment for suspected calciphylaxis. Remarkably, after 1 week the patient reported substantial improvement. Hopefully, this publication in conjunction with previous and future research will raise awareness on the role Radiologists can play in expediting the diagnostic process for a lethal disease, especially when a tissue biopsy is not a feasible option.