Another helpful diagnostic clue is the presence of phleboliths ( Figs. Marked diffuse enhancement of the slow-flowing venous channels on delayed postcontrast T1-weighted images is characteristic of venous malformation ( 11). Heterogeneous signal intensity on T1-weighted images from hemorrhage or the presence of protein content is not uncommon ( 11).

They are frequently incorrectly referred to as “cavernous hemangiomas.” On magnetic resonance (MR) images, they usually present as septated or tubular lesions with hypointensity on T1-weighted images and increased signal intensity on T2-weighted images ( Fig. They are the most common peripheral vascular malformations, and occur in the head and neck (40%), trunk (20%), and extremities (40%) ( 11, 12). This is a rare case of adult-onset dermatomyositis showing subcutaneous fat calcinosis exclusively.Vascular malformations are categorized as low-flow malformations (venous, lymphatic, capillary, capillary-venous, and capillary-lymphatic-venous) or high-flow malformations (arteriovenous malformations and arteriovenous fistulas) ( 11). Whole body bone scintigraphy has been demonstrated to be useful and more sensitive than plain radiographs in the detection of extraosseous calcification.

Mechanism of these calcium deposits is not clear, but it could result from an intracellular accumulation of calcium secondary to an alteration of the cellular membrane by traumatism and inflammation. Calcinosis universalis is characterized by the deposit of calcium salts in skin, subcutaneous tissue, tendons and muscles without any metabolic disorder or tissue injury. Calcinosis in connective tissue diseases is associated with persistent disease activity and disease chronicity. Single photon emission computed tomography/computed tomography (CT) (a) coronal CT, (b) coronal fused, (c) transaxial CT and (d) transaxial fused images of the pelvis and upper part of bilateral thighs showed tracer localization to extensive calcification exclusively in the subcutaneous fat of buttocks and anterior and lateral part of thigh (arrow on right sided involvement) on both sidesĬalcinosis is a well-documented manifestation seen in up to 40% of patients with juvenile dermatomyositis, but is an uncommon feature in adult-onset dermatomyositis. Single-photon emission computed tomography/computed tomography images d] of the pelvis and upper part of bilateral thighs showed tracer localization to extensive calcification exclusively in the subcutaneous fat of buttocks and anterior and lateral part of thigh on both sides, with normal pelvic viscera. Whole-body bone scintigraphy performed to assess the extent of calcinosis showed multiple areas of irregular tracer deposition in the soft tissues of right upper limb, left arm, in the bilateral gluteal region, anterior and posterior aspects of the thighs and anterior aspect of bilateral proximal part of the leg. Radiograph of the right arm showed soft tissue calcification around the right humerus. On examination, multiple palpable nodules were found in the region of the right arm and right gluteal region. A 52-year-old female patient with known dermatomyositis diagnosed 2 years back, presented with complaints of low backache and limitation of movements around bilateral hip joints.