Calcium Deposits of the Metacarpophalangeal Joint on the Fourth and Fifth Finger

Abstract

Acute calcium deposition disease is characterized by calcium hydroxyapatite crystal deposition within tendons and surrounding tissue of joints. It can manifest acute or chronic. It’s most common symptom is pain in affected area. Two patients applied to our outpatient clinic with complaints of hand pain. Calcific masses were detected by radiological imaging. After radiological imaging and laboratory examinations the patients diagnosed acute calcium deposition disease. One of the patients had ongoing symptoms for 2 years, the other one had ongoing symptoms for 3 years. Both of the patients had tried conservative treatment multiple times. These patients were treated surgically because of long-standing symptoms. Although acute calcium deposition disease usually resolves spontaneously with conservative treatment, patients with recurrent or persistent lesions can be treated surgically.

Keywords

• calcium depsits
• hand surgery
• peritendinitis
• periarthritis

Dördüncü ve Beşinci Parmak Metakarpofalangeal Eklemde Kalsiyum Depolanması

Öz

Akut kalsiyum birikimi hastalığında hidroksiapatit birikimi meydana gelmektedir. Bu durum, eklemleri çevreleyen tendonlarda ve dokularda oluşmaktadır. Akut veya kronik olarak kendini gösterebilir. En sık görülen semptom etkilenen bölgede ağrıdır. İki hasta polikliniğimize el ağrısı şikayeti ile başvurdu. Radyolojik görüntüleme ile kalsifik kitleler tespit edildi. Radyolojik görüntüleme ve laboratuvar incelemelerinin ardından hastalara akut kalsiyum depo hastalığı tanısı konuldu. Hastalardan birinin semptomları iki yıldır, diğerinin semptomları üç yıldır devam ediyordu. Her iki hasta da konservatif tedaviyi defalarca denemişti. Bu hastalar uzun süredir devam eden semptomlar nedeniyle cerrahi olarak tedavi edildi. Akut kalsiyum birikimi hastalığı genellikle konservatif tedavi ile kendiliğinden düzelse de, tekrarlayan ağrı semptomları ve kalıcı lezyonları olan hastalar cerrahi olarak tedavi edilebilir.

Anahtar Kelimeler

• Kalsiyum depo hastalığı
• kalsifik peritendinit
• kalsifik periartrit
• el cerrahisi

Kaynakça

1. 1. Lehmer LM, Ragsdale BD. Calcific periarthritis: more than a shoulder problem: a series of fifteen cases. JBJS, 2012, 94.21: e157.
2. 2. Doumas C et al. Acute calcific periarthritis of the hand and wrist: a series and review of the literature. Emergency radiology, 2007, 14.4: 199-203.
3. 3. Garcıa GM, Mccord GC, Kumar R. Hydroxyapatite crystal deposition disease. In: Seminars in musculoskeletal radiology. Copyright© 2002 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.:+ 1 [phone], 2003. p. 187-194.
4. 4. Moradi A, Kachooei AR, Mudgal CS. Acute calcium deposits in the hand and wrist. Journal of Hand Surgery, 2014, 39.9: 1854-1857.
5. 5. Sandstrom C. Peritendintis calcarea. A common disease of middle life: its diagnosis, pathology and treatment. AJR, 1938, 40: 1-21.
6. 6. Yosıpovıtch G, Yosıpovıtch Z. Acute calcific periarthritis of the hand and elbows in women. A study and review of the literature. The Journal of Rheumatology, 1993, 20.9: 1533-1538.
7. 7. Gosens T, Hofstee DJ. Calcifying tendinitis of the shoulder: advances in imaging and management. Current rheumatology reports, 2009, 11.2: 129-134.
8. 8. Uhthoff HK, Loehr JW. Calcific tendinopathy of the rotator cuff: pathogenesis, diagnosis, and management. JAAOS-Journal of the American Academy of Orthopaedic Surgeons, 1997, 5.4: 183-191.

9. 9. Chung CB, Gentılı A, Chew FS. Calcific tendinosis and periarthritis: classic magnetic resonance imaging appearance and associated findings. Journal of computer assisted tomography, 2004, 28.3: 390-396.
10. 10. Moyer RA, Bush DC, Harrıngton TM. Acute calcific tendinitis of the hand and wrist: a report of 12 cases and a review of the literature. The Journal of Rheumatology, 1989, 16.2: 198-202.
11. 11. Tomorı Y, Nanno M, Takaı S. Acute calcific periarthritis of the proximal phalangeal joint on the fifth finger: A case report and literature review. Medicine, 2020, 99.31.
12. 12. Nıkcı V, Doumas C. Calcium deposits in the hand and wrist. JAAOS-Journal of the American Academy of Orthopaedic Surgeons, 2015, 23.2: 87-94.