MSK and sports case 3

Findings:

• Coronal T2, coronal STIR and axial T2 MRI images show a T2 hypointense ovoid structure along the radial collateral ligament of 4th digit metacarpo-phalangeal joint.
• Diffuse soft tissue edema surrounding this structure.
• CT axial and coronal images confirm peri-articular calcification. 

Diagnosis:

Acute calcific peri-arthritis

Discussion:

• Acute calcific periarthritis is a type of hydroxyapatite deposition disease (HADD) resulting in a painful mono-arthritis.
• It is the same pathology as calcific tendonitis or calcific bursitis, occuring in a peri-articular location.
• Accurate diagnosis necessary to avoid labeling as infection or tumor.
• Responds well to conservative therapy and barbotage (ultrasound guided aspiration of calcific deposit).