Multifocal Skeletal Muscle Mineralisation Following Severe Trauma and Prolonged Critical Illness: A Case Report

Soft tissue mineralisation is an uncommon complication of severe trauma and critical illness and may occur in association with metabolic derangements, tissue injury and prolonged immobilisation. We present a case of a 26-year-old male patient who developed extensive skeletal muscle calcification following multiple stab wounds, hypovolemic shock, and surgical interventions, including limb amputation and bowel resections. Initial imaging showed no calcification; however, six weeks post-injury, CT demonstrated extensive amorphous calcification in the abdominal wall, chest, iliopsoas, and gluteus maximus. This case highlights the importance of recognising skeletal muscle mineralisation in critically ill trauma patients and the role of multimodal imaging in early diagnosis and management. The aetiology may relate to a catabolic state and disuse, causing osteoclastic bone resorption, demineralisation, and elevated serum calcium with subsequent soft tissue deposition. Soft tissue mineralisation in critically ill trauma patients has been described in association with metabolic derangements and tissue injury. This case also highlights the diagnostic challenges in distinguishing soft tissue calcification, heterotopic ossification, and contrast enhancement in critically ill trauma patients.