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CLINICAL IMAGES
Year : 2016  |  Volume : 144  |  Issue : 1  |  Page : 141-142

Acro-osteolysis & calcinosis in scleroderma


1 Department of Pulmonary, Critical Care & Sleep Medicine, University of Texas Health Science Center at Houston, TX, USA 77030, USA
2 Department of Internal Medicine, Coimbatore Medical College, Coimbatore 641 018, Tamil Nadu, India

Date of Web Publication3-Nov-2016

Correspondence Address:
Sujith V Cherian
Department of Pulmonary, Critical Care & Sleep Medicine, University of Texas Health Science Center at Houston, TX, USA 77030
USA
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0971-5916.193303

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How to cite this article:
Cherian SV, Thampy E. Acro-osteolysis & calcinosis in scleroderma. Indian J Med Res 2016;144:141-2

How to cite this URL:
Cherian SV, Thampy E. Acro-osteolysis & calcinosis in scleroderma. Indian J Med Res [serial online] 2016 [cited 2020 Oct 22];144:141-2. Available from: https://www.ijmr.org.in/text.asp?2016/144/1/141/193303

A 74 yr old female, who was referred to Pulmonary and Critical Care Department at the University of Texas Health Science Center at Houston, Texas, USA, in July 2014 for critical aortic stenosis, reported a history of being diagnosed with scleroderma 15 years back, but had never sought treatment. At the time of examination, she had severe flexion contractures, sclerodactyly of fingers with shortening of terminal phalanges, as well as bony deformity involving her right elbow. Radiographs of her hands revealed acro-osteolysis of her digits (red arrows), and calcinosis (blue arrows) involving her wrist, elbow and shoulders [Figure 1] and [Figure 2]A and B. Laboratory profile was significant for markedly high levels of anti Scl-70 (anti-topoisomerase 1 antibody) of > 8 AI (Normal range - < 0.9). The patient refused further treatment and was discharged.
Figure 1:

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Figure 2

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Acro-osteolysis (bony resorption of terminal digital tufts) and calcinosis represent rare hand manifestations of scleroderma. Both these manifestations are associated with vascular complications, highlighting a potential role of vascular injury. Calcinosis, or dystrophic soft tissue calcification, occurs in damaged and devitalized tissues from the deposition of amorphous calcium hydroxyapatite crystals. Medical therapy of both these conditions is limited.


    Figures

  [Figure 1], [Figure 2]



 

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