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A 59-year-old woman presented to the emergency department because of lower abdominal discomfort and fever for 3 days. She had a history of end-stage renal disease for which she had received haemodialysis for 10 years. On arrival, her vital signs were stable. Physical examination was unremarkable. Enhanced computed tomography of the abdomen and pelvis showed tumoral calcinosis of bilateral hip joints (asterisk) and lobulated cystic lesions (arrow) surrounding the soft tissue of the hips (fig 1). A percutaneous aspiration obtained milky white turbid fluid. On cytological examination, abundant calcified amorphous deposits and mononuclear histiocytes were noted. Bacterial cultures failed to yield any pathogens, including Mycobacterium tuberculosis.
Tumoral calcinosis is an uncommon and benign condition characterised by the presence of calcified periarticular soft tissue masses located around large joints. By releasing local or systemic proinflammatory cytokines, tumoral calcification may elicit a systemic inflammatory response in patients undergoing haemodialysis.1
Acknowledgments
This article has been adapted from Chen Y-L, Chang W-C, Chu S-J, Tsai S-H. Tumoral calcinosis of bilateral hip Emergency Medicine Journal 2008;25:97
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Footnotes
Competing interests: None.