Abstract
Juvenile Dermatomyositis (JDM) is a rare autoimmune disease in children and adolescents. In these patients calcinosis might be the most characteristic symptom. However there are only few reported cases of intramuscular calcinosis in Dermatomyositis. We report a case of calcinosis universalis (CU) of the elbow in JDM successfully treated with broaching. The patient, a 24-year-old woman, suffered from a long history of JDM. On examination she presented with a fistula lateral to the olecranon and pain of the right elbow joint. Plain X-rays displayed a diffuse pattern of multiple periarticular, subcutaneous, and intramuscular calcifications. The patient underwent surgery for histological and microbiological sampling as well as broaching. Intraoperatively sinus formation and subfascial hard calcium deposition were found. Due to the risk of collateral tissue damage, incomplete broaching was performed. A local infection with Staphylococcus was diagnosed and treated with antibiotics. On six-week and 30-month follow-up the patient was free of pain and had very good function. Calcifications on standard radiographs had almost resolved entirely. This case report gives a summary on calcinosis in Dermatomyositis and adds a new case of recalcitrant CU to the literature. Broaching surgery proved to be a reliable treatment option in symptomatic calcinosis.
Highlights
The incidence of juvenile Dermatomyositis (JDM) varies between two and seven per 1000000 per year [1, 2]
We report a case of calcinosis universalis (CU) of the elbow in Juvenile Dermatomyositis (JDM) successfully treated with broaching
Calcifications on standard radiographs had almost resolved entirely. This case report gives a summary on calcinosis in Dermatomyositis and adds a new case of recalcitrant CU to the literature
Summary
The incidence of juvenile Dermatomyositis (JDM) varies between two and seven per 1000000 per year [1, 2]. JDM presents with symmetric weakness of proximal muscles and impaired general condition with malaise and fatigue. This condition is typically accompanied by dermal alterations and rash. The association of subcutaneous and soft tissue calcific deposits with JDM is estimated from 20 to 70% of the cases [2,3,4]. The deposits are characterized by insoluble calcium salts, previously specified as calcium hydroxylapatite [4] They are found in soft tissues either subcutaneously or in deeper layers. Calcinosis may present in a localized or a disseminated pattern in the patient’s body. It occurs in the fingertips or the extensor aspects of the joints. Our report highlights a rare case of massive calcinosis of the elbow and describes the clinical symptoms, intraoperative findings, and the outcome six and 30 months postoperatively
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
