PMC4633560_01
Right elbow of a 24-year-old woman with calcinosis universalis in juvenile Dermatomyositis; posterior view: fistula formation accompanied by erythema, swelling, and secretion of a blood tinged, serous secretion lateral to the olecranon.
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Blood tinged, serous secretion lateral to the olecranon was noticed (Figure 1).
Standard elbow radiographs of a 24-year-old woman with calcinosis universalis in juvenile Dermatomyositis. (a) Anterior-posterior radiograph, (b) lateral radiograph.
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Standard radiographs of the left elbow (Figures 2(a) and 2(b)) showed multiple diffuse larger opacities along the myofascial planer of the triceps tendon and smaller ones partly intramuscular.
Sagittal T1 MRI scan of the right elbow of a 24-year-old woman with calcinosis universalis in juvenile Dermatomyositis with circumscribed areas of decreased signal intensity. No intra-articular effusion.
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The initiated MRI ruled out an intra-articular affection (Figure 3).
Intraoperative findings: (a) drainage of a white, crumbly paste via a sinus in calcinosis universalis associated with juvenile Dermatomyositis. (b) Subfascial preparation and broaching of the calcium deposits in the musculus triceps brachii and its tendon.
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On compression a white, crumbly deposit drained via the sinus (Figure 4(a)). The operative exploration disclosed subfascial, calcific deposits of the musculus triceps brachii itself and its tendon (Figure 4(b)).
Broached material of the right elbow in a patient with calcinosis universalis associated with juvenile Dermatomyositis.
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Approximately ten millilitres of a white and yellowish crumbly paste with hard portions was removed (Figure 5).
Standard elbow radiographs of a 24-year-old woman six weeks after cautious broaching of large calcific lesions in calcinosis universalis associated with juvenile Dermatomyositis of the musculus triceps brachii and its tendon plus resection of an ulcerating sinus on (a) anterior-posterior radiograph, (b) lateral radiograph.
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Standard radiographs of the left elbow (Figures 6(a) and 6(b)) showed a remarkably reduced calcium deposit without new formation in vicinity to the operation site.
Standard elbow radiographs of a 24-year-old woman six months after cautious broaching of large calcific lesions in calcinosis universalis associated with juvenile Dermatomyositis of the musculus triceps brachii and its tendon plus resection of an ulcerating sinus on (a) anterior-posterior radiograph, (b) lateral radiograph.
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Laboratory analysis of CRP and ESR was unremarkable; six months postoperatively further spontaneous resorption had occurred (Figures 7(a) and 7(b)).
Standard lateral elbow radiograph of a 26-year-old woman 30 months after cautious broaching of large calcific lesions in calcinosis universalis associated with juvenile Dermatomyositis of the musculus triceps brachii and its tendon plus resection of an ulcerating sinus.
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The lateral X-ray showed further dissolving of the remaining calcific deposits (Figure 8).