Presentation of calcinosis cutis universalis in mixed connective tissue disorder: an encounter during hip arthroplasty.
Munis AshrafKrishnanunni GopikrishnanBalaji UmamahesvaranSenthil Nathan SambandamPublished in: BMJ case reports (2017)
A woman aged 23 years with a diagnosis of mixed connective tissue disorder presented with left groin pain extending over 6 months. Workup revealed avascular necrosis of the femoral head (Grade 3) secondary to systemic lupus erythematosus and chronic steroid intake. An uncemented total hip arthroplasty was considered as the patient was only in the third decade of life. During the preop workup, careful clinical assessment had revealed multiple subcutaneous nodules affecting the extensor musculature limited to the gluteal region, anterior and posterior aspects of the thigh. The diagnosis of calcinosis cutis universalis was made after a CT revealed calcified nodules in the subcutaneous, subfascial and muscular planes. A total hip arthroplasty using the posterior approach was performed with minimal trauma to the calcified nodules and thereby preventing a source of persistent drainage and reducing morbidity due to infection.
Keyphrases
- total hip arthroplasty
- systemic lupus erythematosus
- case report
- single cell
- chronic pain
- computed tomography
- disease activity
- ultrasound guided
- contrast enhanced
- neuropathic pain
- magnetic resonance imaging
- trauma patients
- spinal cord injury
- positron emission tomography
- weight gain
- total knee arthroplasty
- high intensity