cxr: multiple calcifications

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PROF MAHESHKUMAR’S UNIT DR R VIJAYANAND

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  • 1. PROF MAHESHKUMARS UNIT DR R VIJAYANAND

2. 55 years old gentleman from Rajasthan comes with h/o recurrent respiratory infections

  • No h/o prior antituberculous therapy
  • Non smoker

3. 4. 5. Chest xray PA View showing

  • Multiple soft tissue calcification
  • Multiple healed parenchymal lesions
  • Calcified worm
  • bronchiectasis

6. Causes forsoft tissue calcification DYSTROPHIC Diseasedtissue Normalserum CALCIUM Damaged heart valves TB LYMPH NODES Atherosclerosis Stroma of some tumours < psammoma bodies >

  • METASTATIC
  • Normal tissues
  • Disorder of calcium metabolism
  • CKD
  • Hyperparathyroidism
  • Sarcoidosis
  • Milk alkali syndrome
  • HyperVitaminosisD
  • Commonly seen in kidneys
  • Lungs
  • Stomach-fundal glands
  • cornea

7. Soft tissue calcification

  • Arterial calcification-aging,primary or secondary hyperparathyroidism,werners syndrome.
  • Venous calcification-thrombosed veins, varicose veins
  • Nerves- leprosy,neurofibromatosis
  • Haematomas- cephal haematomas

8.

  • 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 calcinosisuniversalis
  • -TB lymph node,Im injections, snakebites,frost bite,

9.

  • Tendon supraspinatus tendon
  • Diffuse systemic sclerosis
  • Calcification of tumours- haemangiopericytoma, medullary carcinoma of thyroid, thyroid adenoma
  • Parasiticcalcification-guinea worm, loa loa, cysticercus cellulosae, trichinella spiralis

10. Guinea worm[Dracunculensis medinensis]

  • Vector borne nematode infestation of soft tissue
  • Common in gujarat, rajasthan
  • Last case in india july - 1996
  • India declared free of guinea worm - 2000

11. LIFE CYCLE

  • drinking water infected
  • Withcyclops
  • 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

12.

  • Wherestepwellsare the source of water supply
  • Transmission occurs
  • Eradication is possible by provision of safe drinking water, control of cyclops,health education
  • Treatment Niridazole,Mebendazole,Metronidazole

SOFT TISSUE SWELLINGS WORM FROM BLISTER 13. References

  • Sutton textbook of radiology
  • Park textbook of social&preventive medicine
  • Fishman textbook of respiratory diseases
  • Internet
  • Robbins textbook of pathology

14.