DISCUSSION
Aromioclavicular pain is a common condition usually arising due to
traumatic causes and less commonly due to atraumatic causes such as
infections and arthritis.2 Acute calcific
periarthritis is a rarely diagnosed condition of acromioclavicular joint
and frequently misdiagnosed as septic arthritis and fractures. This is
especially the case when calcification involves the joints other than
shoulder.4 Mostly affecting the people between
4th and 6th decades, calcific
periarthritis shows equal sex distribution.1
Acute calcific periarthritis can present with varying signs and symptoms
including pain, redness, swelling and limited movements of the
joint.5 The pathophysiology can be described as the
deposition of hydroxyappatite along with inflammatory cells, mostly
neutrophils.6
Several imaging modalities are helpful in diagnosing the condition.
Radiography is the key diagnostic modality for evaluating calcific
deposition. Sequential x-ray films are cost effective and helps in
recognizing change in the size and location, and even spontaneous
disappearance .7,8 Ultrasound is useful in both
diagnostic and therapeutic purpose, particularly in the
shoulder.9
Treatment options include conservative and surgical therapy. Nonsurgical
therapy is the mainstay of treatment, with NSAIDs, physical therapy,
local hot or cold compression and corticosteroid injections comprising
first- line treatment.1,10
Although the presentation of acute calcific periarthritis may confuse
the clinicians leading to misdiagnosis, the radiographic finding of
calcification is highly suggestive of the diagnosis. Patient may be
subjected to various diagnostic and invasive procedures such as joint
aspiration due to lack of familiarity to this
condition.4 Hence it is of utmost important to be
aware of this disease condition so as to minimize incorrect diagnoses.