Calcification disorders in man
Pathological calcification can affect a number of different organs and associated with different diseases. The most common organs affected are the cardiovascular system (arterial calcification in atherosclerosis, valve calcification), cartilage and joint tissue calcification (in osteoarthritis and post-trauma as in calcific tendinitis and synovial calcification) and in skin (chronic skin ulcers, calcinosis associated with connective tissue diseases).
Calcific tendinitis
Calcific tendinitis affects 3-11% of the adult population, in particular between 30-60 y of age and 50% are symptomatic. Rotator cuff and Achilles tendon are sites most frequently affected.
Most cases are self-limiting, but chronic persistent calcification occurs in about 15% of cases. Surgery is the option in 10% of these cases.
X- ray of shoulder showing calcification of the rotator cuff causing pain and limitation.
Skin calcification
Soft tissue calcification affects 18% of scleroderma patients (prevalence is 1/6500 adults) and between 10-30% of dermatomyositis patients (prevalence between 1/50K in the adult form to 1/500K in juvenile form). Calcification can ulcerate, cause pain and recurrent inflammation.
Both are serious connective tissue diseases usually treated with major immunosuppressives. These drugs however have no effect on calcification. No treatment exists currently for this condition.
X- ray showing skin and subcutaneous calcification in a patient with scleroderma. Deposits can ulcerate and cause chronic pain and loss of function.
Other calcification disorders
Calciphylaxis - sudden onset of vascular occlusion due to calcification of blood vessels - leading to tissue necrosis, ulcers. It is a known complication of end stage renal disease.
Vascular calcification is a common complication of atherosclerosis and diabetes, with calcium deposits found in arteries and veins. Coronary calcification is associated with ischemic heart disease and an indicator of the severity of coronary atherosclerosis. Calcification can also occur on heart valves and in veins.