Images in Clinical Medicine

Kim Eagle, M.D., Editor

Metastatic Calcification of the Shoulder in Chronic Renal Failure

Hamid Rabb, M.D., and German Ramirez, M.D.

N Engl J Med 1993; 329:695September 2, 1993

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Article

Figure 1 Metastatic Calcification of the Shoulder in Chronic Renal Failure.

A 32-year-old man with chronic renal failure (from IgA nephropathy) being treated with maintenance hemodialysis began to take his phosphate-binding medications irregularly, and swelling of the right shoulder developed over a period of two months. The calcium-phosphate product (in milligrams per deciliter) was more than 90, and the serum N-terminal parathyroid hormone level was elevated. A biopsy of the shoulder mass (arrow) revealed hydroxyapatite. The patient underwent subtotal parathyroidectomy and was referred for renal transplantation.

Kim Eagle, M.D.

Hamid Rabb, M.D.
German Ramirez, M.D.
James A. Haley Veterans Affairs Hospital, Tampa, FL 33612

Citing Articles (1)

Citing Articles

1. 1

   (1994) Renal Transplantation in a Noncompliant Patient. New England Journal of Medicine 330:5, 371-372
   Full Text

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