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e-CASES: Acute calcific tendinitis of Flexor Carpi Ulnaris

Mr Channel Musculoskeletal

Anamnese

Acute medial wrist pain in a 30-year old male, aggravated by flexion and ulna deviation of the wrist

Ergebnisse

@1.1 ,@2.1 Xray of the wrist demonstrating calcium deposits proximal to the pisiform without any cortical changes

@3.1 Ultrasound showing calcium deposits and hypervascularisationdoppler sonography


Diagnose

Acute calcific tendinitis of Flexor Carpi Ulnaris


Diskussion

DEFINITION

Acute calcific tendinitis of Flexor Carpi Ulnaris is an unusual, painful, monoarticular, periarticular inflammatory process associated with juxtaarticular deposits of amorphous calcium hydroxyapatite.

 

CHARACTERISTIC CLINICAL FEATURES AND RADIOLOGIC FINDINGS

ACT of FCU has a high rate of misdiagnosis because of its rare occurrence and its clinical resemblance to other entities with wrist tenderness and swelling. One third of patients with ACT provide an history of trauma.

In most cases, treatment is conservative; it consists of immobilization plus nonsteroidal antiinflammatory drugs or local steroid injections. Results are uniformly good.

Failure to recognize this entity may cause unnecessary investigation and therapy.


DDx

Clinical presentation may simulate infection, and the associated periarticular calcifications may be mistaken for gout, pseudogout, or other entities.


Referenzen

  1. Edmondson M, Skyrme A. Occupationally related bilateral calcific tendonitis of Flexor carpi ulnaris: case report. J Orthopaed Surg Res 2009;4:33.
  2. Moyer RA, BushDC, Harrington TM. Acute calcific tendinitis of the hand and wrist: a report of 12 cases and a review of the literature. J Rheumatol 1989;16:198–202.
  3. The Journal of Emergency Medicine, Vol. 44, No. 2, pp. 352–354, 2013


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