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PROF MAHESHKUMAR’S UNITDR R VIJAYANAND
55 years old gentleman from Rajasthan comes with h/o recurrent respiratory infectionsNo h/o prior antituberculous therapyNon smoker
Chest xray PA View showingMultiple soft tissue calcificationMultiple healed parenchymal lesions Calcified wormbronchiectasis
Causes for soft tissue calcification
DYSTROPHIC
Diseased tissue
Normal serum CALCIUM Damaged heart valvesTB LYMPH NODESAtherosclerosisStroma of some tumours<psammoma bodies>
METASTATICNormal tissuesDisorder of calcium metabolismCKDHyperparathyroidismSarcoidosisMilk alkali syndromeHyperVitaminosis D
Commonly seen in kidneys<basement membranes>Lungs<alveolar wallsStomach-fundal glandscornea
Soft tissue calcification
Arterial calcification-aging,primary or secondary hyperparathyroidism,werner’s syndrome.
Venous calcification-thrombosed veins, varicose veins
Nerves- leprosy,neurofibromatosis
Haematomas- cephal haematomas
Metabolic - hyperparathyroidism, vit-D overdose, chronic renal failure
Soft tissue necrosis followed by calcification
Subcutaneous fat necrosis & calcification – ehlers danlos syndrome , christian weber syn
Extensive soft tissue calcification in dermatomyositis – ‘calcinosis universalis’
-TB lymph node,Im injections, snakebites,frost bite,
Tendon – supraspinatus tendon
Diffuse systemic sclerosis
Calcification of tumours- haemangiopericytoma, medullary carcinoma of thyroid, thyroid adenoma
Parasitic calcification-guinea worm, loa loa, cysticercus cellulosae, trichinella spiralis
Guinea worm [Dracunculensis medinensis]Vector borne nematode infestation of soft
tissueCommon in gujarat, rajasthanLast case in india july - 1996India declared free of guinea worm - 2000
LIFE CYCLE drinking water infected
With cyclops
Man acquires infection
Larvae released & penetrate the duodenal wall
Larvae Mature&reproduce
Migrates through viscera to subcutaneous tissues
Fertilzed female worm migrates to skin surface
Causes blister ruptures releases larvae
Where stepwells are the source of water supply
Transmission occursEradication is possible
by provision of safe drinking water, control of cyclops,health education
Treatment – Niridazole,Mebendazole,Metronidazole
SOFT TISSUE SWELLINGS
WORM FROM BLISTER
References Sutton textbook of radiologyPark textbook of social&preventive medicineFishman textbook of respiratory diseasesInternetRobbins textbook of pathology