Calcinosis of the Hand in Scleroderma: A Case Report

Abstract

Calcinosis associated with scleroderma is a well recognized phenomenon. Fifteen to 44% of patients with systemic scleroderma and associated CREST (calcifications, raynaud's phenomenon, esophageal motility disorder, sclerodactyly and telangiectasias) syndrome have deposition of calcium in the fingers and hands. The tumourous effect may limit motion, cause neuropraxia, compound microangiopathy or present as calcific ulcers. This report describes the case of a patient with scleroderma and CREST syndrome in whom calcinosis in the hand resulted in severe, debilitating pain necessitating surgical evacuation of the deposits. The patient had complete pain relief in the postopertive period. A further surgical extirpation of calcium was required for recurring pain at six months after surgery. The patient has remained symptom free since that time. The rare occurence of excruciating pain prompted this report and literature review.