January Case of the Month


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Authors: James H. Wang, MD, PGY-1, Radiology Resident, Diagnostic Radiology, University of South Florida Health System, Tampa, Fla., Daniel Amirhamzeh, MD, PGY-4, Radiology Resident, Diagnostic Radiology, Santa Barbara Cottage Hospital, Santa Barbara, Calif., and Bernard Chow, MD, Section Chief, Musculoskeletal Imaging, Santa Barbara Cottage Hospital, Santa Barbara, Calif. 

Why did you select this case for submission?

Acute calcific periarthritis (ACP) is a form of hydroxyapatite deposition disease and is a rare cause of acute, severe juxta-articular hand pain. Diagnosis is often delayed because the presentation of ACP may be indistinguishable from that of gout, pseudogout, or septic arthritis. It is a great learning case as it challenges the participant to thoroughly evaluate the differentials.

What should readers learn from this case?

ACP is a self-limited condition caused by the deposition of hydroxyapatite crystals in tendons, bursae, and soft-tissue spaces surrounding a joint. Awareness of the clinical and radiographic features of this self-limited condition averts further testing and unnecessary diagnostic and therapeutic interventions.

What did you learn from working on the case?

Although the imaging technology and knowledge are expanding at an increasingly rapid rate, the key to making the diagnosis for ACP is still plain radiographs. Radiologists are thus uniquely positioned to provide quality recommendations that are based on accurate recognition and clinical knowledge and, in turn, provide tremendous value to referring physicians and patients.

How did guidance from senior staff at your institution impact your learning and case development?

Encouragement and support from the senior staff were pivotal. Their collective knowledge and clinical experiences were the foundation to the recognition and completion of this unique case.

Why did you choose Case in Point for submission of your case?

There is no subscription fee, which allows total accessibility to quality content. ACR Case in Point also provides an interactive platform from which learners can educate themselves from a clinical perspective for daily practice.

What is the appeal of online learning tools such as Case in Point as opposed to print learning venues?

Online learning provides more efficient access to both volume and spectrum of materials. In turn, ACR CiP has become a great reference tool for both training and clinical practice.

Are you a regular reader of Case in Point? What are your favorite types of cases?

As a learner and a contributor, I read a variety of cases regularly for fundamental knowledge as well as for ideas and ways I can improve the educational value of the cases that we submit.

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