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Calcinosis Cicumscripta. Calcinosis Circumscripta. Uncommon syndrome of ectopic idiopathic, dystrophic, metastatic or iatrogenic mineralization Human beings Circumscripta Universalis Monkeys, dogs, cats, horses, cows, a buffalo, a rabbit and a captive sitatunga. Calcinosis Circumscripta. - PowerPoint PPT Presentation
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Calcinosis Cicumscripta
Calcinosis Circumscripta
Uncommon syndrome of ectopic idiopathic, dystrophic, metastatic or iatrogenic mineralization
Human beings Circumscripta Universalis
Monkeys, dogs, cats, horses, cows, a buffalo, a rabbit and a captive sitatunga
Calcinosis Circumscripta
The pathogenesis not completely understood calcium salts are deposited in soft tissues in the form of
hydroxyapatite or amorphous calcium phosphateMultiple theories in human orthopedics
repetitive trauma leading to reparative dysfunction periarticular forces dissecting histiocytic aggregates that
initiate osteoclastic activity hemorrhage from microtrauma causing an exaggerated
reparative response.Classified into four major types according to the type of
calcification process and etiology Dystrophic, metastatic, idiopathic, iatrogenic
DystrophicNormal serum calcium and phosphate levels Calcification localized to a specific area of
tissue damagePrimary lesion can be due to injury, necrosis,
inflammation or neoplasia following severe chronic inflammation (reaction to a
foreign body, otitis externa, interdigital pyoderma, demodicosis, neoplasia , apocrine gland degeneration)
IatrogenicArises secondary to a treatment or surgical
procedureCalcification occurring at the invasive site
can also be classified as dystrophic calcificationmedroxyprogestrone and proligestone
injectionspolidioxanone suture material
MetastaticMost often form in human beingsAbnormal calcium or phosphate metabolism-
hypercalcaemia and/or hyperphosphataemia chronic renal failure,end stage kidney disease, vitamin
D toxicosis. Few reports in the veterinary literature
describe calcinosis circumscripta in association with renal failure calcification of foot pads widespread visceral and vascular mineralization also
reported
IdiopathicOccurs in the absence of known tissue injury
or systemic metabolic defect No causative factor identified
Breed and familial predilection can occur Can be inherited as an autosomal recessive trait in
humans Hereditary predilection has been suggested in dogs
Several cases of idiopathic paravertebral calcinosis circumscripta in dogs and human beings Especially cervical spine
Small Animals
Dystrophic and idiopathic forms occur more frequently than the metastatic form
Idiopathic seen most commonly in young, large breed dogs German Shepherds predisposed Paravertebral cervical
77 dogs without renal diseaseMost common in young dogsLesions solitary in 82% of the affected dogs, and occurred
most commonly on the hind feet (50%) and tongue (23%) Multiple other sites including intestinal (1)
Surgical resection curative
Metastatic
HorsesReferred to calcinonosis circumscripta or
tumoural calcinosis Tumoural calcinosis, a hereditary metabolic
dysfunction of phosphate regulation resulting in massive periarticular calcinosis in humans
Horses are rarely lame
HorsesMost commonly lateral aspect of femorotibial joint
sometimes bilaterally can be closely assoc with joint capsule
Neck, carpus and tarsusDocumented invasion in middle carpal joint and
antebrachiocarpal joint. Thought to be of traumatic origin resulting in dystrophic
mineralization ddx Synovial Osteochondromatosis
Uncommon disorder characterized by the formation of multiple, intra-articular, cartilaginous nodules in the synovial membrane as well as metaplasia of subsynovial connective tissues
these lesions commonly undergo secondary ossification and calcification
References
Calcinosis Circumscripta in the Dog: A Retrospective Pathological Study A. K. Tafti, P. Hanna, A. C. Bourque. J. Vet. Med. A(2005) 52: 13–17
Calcinosis circumscripta in the horse, P. I. Milner Equine vet. Educ. (2009) 21 (11): 589
Calcinosis Circumscripta of the Tongue S. W. Douglas, D. F. Kelly. small anim. Pract. (1966) 7:441 -443.
Calcinosis Circumscripta (Calcium Gout) in related Irish Wolfhounds L. N. Owen. small Anim. Pract. (1967) 8: 291-292.
Calcinosis circumscripta following an injection of proligestone in a Burmese cat CR O’Brien, JS Wilkie. Aust Vet J (2001)79:187-189