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Acute calcific periarthritis in a child
Insights
Acute calcification in a child's hand highlights diagnostic challenges. Differentiating calcific periarthritis from infection requires careful clinical and radiographic evaluation.
Area of Science:
- Orthopedics
- Rheumatology
- Radiology
Background:
- Calcific periarthritis involves hydroxyapatite crystal deposits in soft tissues around joints.
- First described in the shoulder, it commonly affects this site, but can occur in other joints.
- Hand involvement is rare, with the first reported case in 1924.
Observation:
- A case study of a child presenting with acute calcification in the thenar eminence.
- This presentation posed diagnostic difficulties, mimicking acute infection on clinical examination.
Findings:
- Hydroxyapatite crystal deposition disease (calcific periarthritis) can manifest in the hand, specifically the thenar eminence.
- Radiographic findings include opacities of variable density and shape around joints.
Implications:
- Highlights the importance of considering calcific periarthritis in hand presentations, even in younger patients.
- Emphasizes the need for thorough clinical and imaging assessment to differentiate from infection.
- Contributes to understanding the rare occurrence of this condition in the hand.
Abstract:
We wish to present an account of a child who developed acute calcification in his thenar eminence to highlight the difficulty in differentiation between calcific periarthritis, acute infection, on clinical grounds. Calcific periarthritis is due to hydroxyapatite crystal deposits in bursae, tendons and ligaments (Bonavita 1980) with characteristic radiographic appearances of opacities of variable density and shape around joints (Hitchcock 1959). The condition was first described in the shoulder, by Duplay in 1870 (Sandstrom 1938) and this remains the most commonly affected site. The hip, elbow, wrist, knee and ankle may also be involved but involvement of the hand is uncommon. Involvement in this site was first described in 1924 by Cohen (Carroll 1955). The previously reported age span ranged from thirteen years upwards, with an average of forty-five years, both sexes being equally affected (Currey 1970, Hitchcock 1959, Bonavita 1980).