Article Text

Download PDFPDF
Case report
Bilateral hamstring origin calcification: rare presentation of Gitelman syndrome
  1. Rahul Mohan1,
  2. Satish Vinayakrao Dhotare1,
  3. P Nithin Unnikrishnan2 and
  4. Chetan Jakaraddi1
  1. 1Trauma and Orthopaedics, St Helens and Knowsley NHS Trust, Prescot, Merseyside, UK
  2. 2Trauma and Orthopaedics, Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust, Oswestry, UK
  1. Correspondence to Rahul Mohan; rahulpidavoor{at}


This case report is the first case to our knowledge of intratendinous or peritendinous calcification reported in Gitelman syndrome (GS) patients. GS represents the clinical manifestations of inactivation of the Slc12a3 genes encoding the thiazide-sensitive sodium chloride cotransporter and the Trpm6-Mg genes encoding the magnesium transporters in the distal convoluted tubule. Hence, the biochemical findings resemble those with thiazide diuretics such as hypokalaemia, hypomagnesaemia, hypocalciuria, metabolic alkalosis and low normal blood pressure. Serum calcium and phosphate levels are usually unaffected in GS unless associated with hyperparathyroidism or other hypercalcaemic aetiologies. We report a 69-year-old male patient with a history of GS who presented with bilateral ischial tuberosity tenderness. Further investigations confirmed the calcification of bilateral hamstring origin. Chondrocalcinosis is a known association of GS; however, extra-articular calcification is rare. Literature review illustrates sclerochoroidal calcification as the only reported soft tissue calcification apart from chondrocalcinosis.

  • orthopaedics
  • musculoskeletal syndromes
  • hamstring
  • groin pain

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Contributors RM planned and prepared the article. NU, SD and CJ helped in the literature review and to organise the article. We all sat together at the end to edit the article before submitting.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.