Acute Calcific Periarthritis Beyond the Shoulder: A Case Report of Fifth MCP Involvement

Area of Science:

• Rheumatology
• Orthopedics
• Crystal Arthropathies

Background:

• Acute calcific periarthritis (ACP) is a self-limiting condition characterized by calcium hydroxyapatite crystal deposition.
• It most commonly affects the shoulder but can occur at other periarticular sites.
• Atypical presentations can mimic other inflammatory conditions, posing diagnostic challenges.

Purpose of the Study:

• To present a case of acute calcific periarthritis (ACP) affecting an atypical site: the metacarpophalangeal joint.
• To emphasize the importance of characteristic imaging findings in diagnosing ACP at unusual locations.
• To highlight the differential diagnosis considerations for acute joint pain and swelling.

Main Methods:

• Case report of a 33-year-old female with acute right fifth metacarpophalangeal joint pain and swelling post-trauma.
• Diagnostic workup included radiography and ultrasonography to identify periarticular calcification.
• Treatment involved non-steroidal anti-inflammatory drugs (NSAIDs), corticosteroids, and joint immobilization.

Main Results:

• Radiographs and ultrasonography confirmed periarticular calcification consistent with ACP.
• The patient experienced a full recovery following conservative management.
• The case illustrates the diagnostic difficulty of ACP presenting at atypical sites, mimicking gout or infection.

Conclusions:

• Acute calcific periarthritis (ACP) can present atypically, requiring careful diagnostic consideration.
• Characteristic imaging findings are crucial for differentiating ACP from other acute joint conditions.
• Prompt and appropriate management leads to favorable outcomes in ACP.