Clinical: 31 y/o female with acute onset of pain, redness, and swelling. No injury. Evaluate for infection or abscess.
Dx: Calcific tendonitis of the adductor hallucis. The xray findings here are very subtle and the MRI really helped out. Old case report attached.
Note: Calcific tendonitis presents acutely and symptoms can be severe; with patients often going to the ER. While it is most common in the shoulder, it essentially can occur anywhere. It is important for the radiologist or clinician to recognize because the imaging findings are pathognomonic. If it is not diagnosed with imaging, the patient is often treated for infection and can undergo unnecessary interventions. Treatment is initially conservative, but there are some surgical and image guided therapeutic options.
Read this related article from Foot & Ankle International.
References:
Muschol M, Petersen W, Hassenpflug J. Foot & Ankle International: April, 2006 – vol. 27, no. 4, pp. 296-298.