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Skeletal Radiology

, Volume 47, Issue 5, pp 729–734 | Cite as

Intraarticular calcifying aponeurotic fibroma of the wrist: mimicking gout or calcium pyrophosphate dihydrate deposition disease

  • Sang Min Lee
  • Doo Hoe Ha
  • Haeyoun Kang
  • Ji Young Rho
Case Report

Abstract

Calcifying aponeurotic fibroma is a rare, benign fibroblastic tumor that typically occurs in the palms of the hands and soles of the feet in children and adolescents. We report an unusual case of a calcifying aponeurotic fibroma with diffuse intra-articular involvement of the carpal joints in a 59-year-old female. Radiographs and computed tomography scans revealed a large lobulated soft tissue mass with multiple stippled calcifications around the carpal joints and numerous erosions of the second to fifth carpometacarpal and intercarpal joints. Magnetic resonance imaging showed diffuse multinodular synovial proliferation with inhomogeneous hypo- to isointense signal intensity on T1-weighted images, inhomogeneous hypointense to hyperintense signal intensity on T2-weighted images, and inhomogeneous intense enhancement on fat-suppressed contrast-enhanced T1-weighted images. Radiologic diagnosis included gout, calcium pyrophosphate dihydrate deposition disease, and tenosynovial giant cell tumor. Surgical excision was performed, and the mass was diagnosed on pathologic examination as a calcifying aponeurotic fibroma. There has been no reported case of a calcifying aponeurotic fibroma with diffuse intra-articular involvement of the carpal joints in the literature.

Keywords

Calcifying aponeurotic fibroma Intraarticular Gout CPPD disease Wrist 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© ISS 2017

Authors and Affiliations

  • Sang Min Lee
    • 1
  • Doo Hoe Ha
    • 1
  • Haeyoun Kang
    • 2
  • Ji Young Rho
    • 1
  1. 1.Department of Radiology, CHA Bundang Medical Center, College of MedicineCHA UniversitySeongnam-siRepublic of Korea
  2. 2.Department of Pathology, CHA Bundang Medical Center, College of MedicineCHA UniversitySeongnam-siRepublic of Korea

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