Calcium deposits in the hand and wrist.

Calcium, or calcific, deposition disease in the form of acute calcific periarthritis of the hand and wrist is an uncommon entity that may be confused with more common crystalline or inflammatory arthropathies as well as infection. It is important for the clinician to be aware of this disease process and to include it in the differential diagnosis of patients presenting with acutely painful, focal inflammation of the hand or wrist. Nonsurgical management is often sufficient; however, considering the self-limited nature of the disease, accurate diagnosis is essential to avoid unnecessary antibiotic or surgical treatment.

Acute calcific periarthritis of the hand and wrist: a series and review of the literature.

This article presents three patients with acute calcific periarthritis (ACP) of the hand and wrist. ACP is an unusual, painful, monoarticular, periarticular inflammatory process associated with juxtaarticular deposits of amorphous calcium hydroxyapatite. ACP is a distinct clinical subset of hydroxyapatite deposition disease. ACP has a high rate of misdiagnosis because of its rare occurrence and its clinical resemblance to other entities. Clinical presentation may simulate infection, and the associated periarticular calcifications may be mistaken for gout, pseudogout, or other entities. One third of patients with ACP provide a history of antecedent trauma. Treatment is conservative. Patients typically will have a reduction in symptoms within 4-7 days after the acute onset of pain. Radiographically, the periarticular mineralization usually resolves or markedly decreases within 2-3 weeks, although on occasion, some calcifications may remain visible for months. Failure to recognize and correlate the typical clinical and radiographic presentation of this disease may lead to unnecessary diagnostic tests, invasive procedures, and inappropriate medication.

The effects of local platelet rich plasma delivery on diabetic fracture healing.

Several studies have documented that diabetes impairs bone healing clinically and experimentally. The percutaneous delivery of platelet rich plasma (PRP) was used in the diabetic BB Wistar femur fracture model to investigate the use of PRP as a concentrated source of critical early growth factors on bone healing. PRP delivery at the fracture site normalized the early (cellular proliferation and chondrogenesis) parameters while improving the late (mechanical strength) parameters of diabetic fracture healing. These results suggest a role for PRP in mediating diabetic fracture healing and potentially other high risk fractures.