PMC9664969_01
Clinical and radiological images (A and B) Physical examination shows white papules (arrowhead) on the surface of the right elbow in the flexed position (A) but not in the extended position (B). (C) X-ray image shows calcinosis in the s.c. lesion on the surface of the right elbow. (D) Ultrasonography shows high echoic lesions in the s.c. lesion (arrowhead). (E) Contrast-enhanced T1-weighted MRI shows high intensity and contrast enhancement of the s.c. lesion in the right elbow (arrowhead), indicating inflammation of the soft tissue, but does not show indications of calcinosis. (F) CT-like magnetic resonance image based on T1 spoiled gradient-echo shows a high-intensity signal in the s.c. region of the right elbow (arrowhead), indicating calcinosis
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The extensor surface of the right elbow was swollen and erythematous, on which white nodules appeared only in the flexed position but not in the extended position (Fig. 1A and B). Radiographs of the right elbow revealed calcification in the s.c. region (Fig. 1C). Musculoskeletal ultrasonography showed high echoic lesions in the space between the skin and triceps muscle, with no signs of acoustic shadow (Fig. 1D). Contrast-enhanced T1-weighted MRI of the right elbow revealed an area of abnormal high intensity with contrast enhancement in the s.c. tissues, a finding consistent with inflammation of soft tissue but not calcification (Fig. 1E). However, CT-like MR images based on T1 spoiled gradient-echo (T1SGRE) showed a high-intensity signal in the s.c. nodules of the right elbow, suggestive of calcinosis (Fig. 1F).