2014, Number 1
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Acta Pediatr Mex 2014; 35 (1)
Evaluation of dystrophic calcinosis in juvenile dermatomyositis and systemic sclerosis
Sáez-de Ocariz M, Carrillo- Rincón A, Murata C, Gutiérrez- Hernández A, Palma-Rosillo RM, Altamirano-Bustamante N
Language: Spanish
References: 18
Page: 7-14
PDF size: 317.44 Kb.
Text Extraction
Background: Dystrophic calcinosis is associated with
juvenile dermatomyositis and systemic sclerosis. Clinical
diagnosis is performed through the detection of subcutaneous,
hard nodules. Conventional radiographic
studies may demonstrate calcium deposits, however,
with very early lesions X-rays may prove insufficient.
There are a few studies where scintilliography has been
used to identify dystrophic calcinosis.
Objectives: To estimate the frequency of dystrophic
calcinosis in patients with juvenile dermatomyositis
and systemic sclerosis/CREST syndrome. To estimate
the concordance between the diagnoses of dystrophic
calcinosis obtained by physical examination and scintigraphy.
Patients and Methods: Observational, transversal and
comparative study in which patients of both genders,
between 5 and 7 years of age with the diagnoses of
juvenile dermatomyositis and systemic sclerosis/CREST
syndrome were included in order to detect dystrophic
calcinosis by physical examination and scintigraphy.
Fisher’s exact test was used to evaluate the association
between both diagnostic methods, Kappa test was used
to evaluate the level of concordance between both
methods and a distribution by group analysis was used
to analyze the extent of dystrophic calcinosis with both
methods. Sensitivity and specificity for scintigraphic
findings in soft tissues, bony protrusions , ribs and
vertebrae was also estimated.
Results: The frequency of dystrophic calcinosis was
80%. Dystrophic calcinosis was detected through
physical examination in 16 patients and through scintigraphy
in 9 patients. No association or concordance
was found between the clinical and the scintigraphic
findings. Scintigraphy has a 37.5% sensitivity for the
detection of dystrophic calcinosis in soft tissues and
43.8% in bony protrusions, but is ideal for its detection
in the ribs.
Conclusions: Both, physicial examination and scintigraphy
are complementary tools for the detection of
dystrophic calcinosis.
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