The symptoms of calcification are caused not so much by its etiology as by the specific location of calcifications. In this case, they themselves appear rarely or not at all, since in most cases they accompany other nosological forms.
The initial calcification can be detected only with the help of hardware visualization - accidentally or when a patient with a blood calcium level is assigned an examination.
But the first signs of formation near the joints of the extremities subcutaneous calcium granulomas, which are soldered to the skin and begin to appear through it as they grow - can be seen without X-rays. This scleroderma calcification of the skin or dystrophic calcification with scleroderma.
Soft tissue calcification
In addition to scleroderma calcification of the skin, calcification of soft palpable tissue can be detected in posttraumatic ossifying myositis : a dense area is felt in the muscle, in which the calcification is deposited. The main symptoms are manifested in the form of intense pain and stiffness of movements, the skin over the lesion blushes, and the subcutaneous tissue swells.
Focal calcification of the gluteus muscles (small or medium) - with moderate soreness of varying strength and swelling - may develop after trauma, burns or intramuscular administration of medications. Severe pain in the buttocks and even stitching on walking causes calcification foci, formed due to arthrosis of the hip joint, sarcoma or progressive congenital Gaucher disease. With paralysis of the extremities, dystrophic calcification affects the muscles of the lower leg and thigh.
And with toxoplasmosis, ochronic disease, or retinal malignant tumor (retinoblastoma), there is calcification of the oculomotor muscles, which keep the eyeball in orbit. Reducing their elasticity prevents the normal movement of the eyes.
When depositing phosphoric-calcium salts in synovial bags of joints and periarticular tissues, metabolic calcification of tendons, ligaments, hyaline and fibrous cartilage is noted. Can be diagnosed: calcifying tendinitis tendon of the supraspinum muscle of the shoulder; Chondrocalcinosis in the ankle, knee and hip joints; calcification of the tendon of the quadriceps muscle of the thigh (in the zone of the tubercle of the tibia or near the patella). In all cases, local pain, signs of local inflammation, and limitation of mobility are noted.
Calcium deposits on the walls of blood vessels most often appear with atherosclerosis, involutional fibrosis of vascular walls, autoimmune and congenital endothelial dysplasia - as dystrophic calcification.
Vessel constriction by 15-25% and slowing of the blood flow, to which calcification of the aortic arch can lead in the places of formation of atherosclerotic plaques, causes the onset of attacks of weakness and headaches; dizziness and fainting; feelings of discomfort in the mediastinum and paresthesia of the fingers. In addition, diffuse calcification of the aorta with a similar symptomatology is observed with syphilitic mezaortite and autoimmune aortoarteriitis.
The pronounced calcification of the thoracic aorta, in addition to the already mentioned symptoms, leads to shortness of breath, arrhythmia and increased blood pressure, pain in the region of the heart, giving to the shoulder, neck, scapula and the area of the hypochondrium. A calcification of the abdominal aorta makes itself felt by a decrease in appetite and total body weight; aching pains in the abdominal cavity associated with eating; problems with the intestines; weight and pain in the legs.
Calcification of the arteries, as a rule, accompanies the same atherosclerosis or age-related decrease in the elasticity of the vascular walls - fibrosis and calcinosis, which affects arterial vessels in the zones of their bifurcation. Thus, calcification of carotid arteries providing blood to the brain, in many patients is detected in the region of the carotid sinus, where the common artery is divided into the outer and inner. The narrowing of the lumen of these vessels, as well as the mouth of the subclavian artery - if there is diffuse calcification of the arteries of the neck - is manifested not only in the form of headache, dizziness, temporary loss of vision, nausea and vomiting, but also neurological symptoms: paresthesia of limbs, movement and speech disorders. The result may be a stroke, for more details see - Stenosis of the carotid artery .
Constantly cold feet, limping, worsening trophism of the skin on the toes (with foci of atrophy and ulceration), pain in the legs, as well as an erection disorder in men, stenosis and obliteration can lead to calcification of the iliac arteries (originating from the split abdominal aorta).
If calcification of the arteries of the lower extremities develops (in half of cases it is atherocalcinosis in the elderly, in others it is a consequence of diabetes mellitus in persons 35 years and older), its typical localization is the superficial femoral artery or the artery of the shin. And among the symptoms, weight and pain in the legs, paresthesia and seizures are noted.
Identifying the calcification of the heart, cardiologists distinguish the calcification of its membranes, supplying them with blood of the coronary arteries and regulating the blood flow of the valves.
In patients with calcifications in the outer shell of the heart (pericardium) or its muscular membrane (myocardium), all signs of heart failure are noted: shortness of breath, pressure and burning behind the sternum, palpitations and pains in the heart, swelling of the legs, sweating at night.
Coronary calcification (calcification of the coronary arteries) has symptoms of angina, that is, expressed dyspnea and radiating to the shoulder chest pains.
Non-rheumatic lesions of cardiac valves with fibrosis, calcification and stenosis include calcification of the aortic valve or calcification of the aortic root in the area of the fibrous ring, which can be defined as degenerative calcification of the aortic valve or degenerative calcified stenosis of its valves. No matter how he is called, he leads to cardiac, coronary or left ventricular failure with the corresponding cardiological symptoms.
The degree of calcification, as well as the degree of stenosis, is established during CT scanning: calcification of aortic valve 1 degree means the presence of one deposit; calcification of the aortic valve of the 2nd degree is determined if the calcifications are several; with diffuse lesions that can seize nearby tissues, a calcification of the aortic valve of the 3rd degree is diagnosed.
Calcification of the mitral valve or mitral calcification accompanies similar symptoms plus hoarseness and coughing attacks.
In the form of focal or diffuse deposits, calcification of the brain is detected with MRI in patients with tumors - teratoma, meningioma, craniopharyngioma, intraventricular epindimoma, adenoma of the pineal gland. Multiple calcifications are formed in gliomas, glioblastomas and giant cell astrocytomas. Among the most common symptoms are severe headaches, visual disturbances, paresthesia and paresis of limbs, tonic-clonic seizures.
Damage to individual structures due to encephalopathies of infectious and parasitic origin (toxoplasmosis, cysticercosis, cryptococcosis, CMV) can cause focal calcifications in the subarachnoid space, in gray and white matter. They manifest themselves in different ways - in accordance with the loss of functions of the neurons of the affected areas.
Often asymptomatic calcification of the basal nuclei (basal ganglia of the brain), as well as the dentate nucleus of the cerebellum, is noted in old age. And with the hereditary disease of the Farah, which can manifest itself in adults of different ages, neurodegenerative changes (cognitive and psychic) are steadily progressing.
Calcification of bones and joints
Dystrophic calcification of bones accompanies almost all bone growths. For example, in benign osteochondria on tubular and flat bones cartilaginous growths are formed, in which calcium salts are deposited. Such calcified growths can be painful and impair mobility.
Calcification of the lower extremities - with bone sarcoma, affecting the tissue of the tubular bones (hip, small or tibial) - pain and deformity increase, leading to disruption of motor functions.
Given the tendency of glycosaminoglycans of connective periarticular tissues and cartilages to attract Ca2 +, calcification of the joints can be considered a comorbid process in the development of joint diseases, especially when their chronic forms are characteristic of people of mature and advanced age.
Calcification of the shoulder joint, ulnar and radiocarpal, calcification in the hip joint zone, calcification of the knee joint with the deposition of calcium hydrate of calcium pyrophosphate in the synovial membrane or articular bag, cause inflammation, swelling, severe pain and leads to limitation of limb mobility.
Calcification of visceral organs and glands
First of all, lung calcification is associated with tuberculosis (in which tuberculosis granulomas and areas of adjacent necrotic tissues are calcified). Calcifications can be exposed to the lungs and bronchi in patients with chronic pneumoconiosis (silicosis, asbestosis, etc.) or parasitic pneumocystoses (ascariasis, toxoplasmosis, echinococcosis, etc.); in the presence of cysts or due to damage after prolonged forced ventilation of the lungs.
Calcifications appear in the lungs in patients with sarcoidosis or metastatic leukemia. About calcification of the pleura read the article - Pleural fibrosis and calcification
KALZINOSIS OF KIDNEYS
Symptoms of renal insufficiency - polyuria, nausea, thirst, convulsions, general weakness, low back pain - manifested itself nephrocalcinosis or dystrophic renal calcification, chronic form of glomerulonephritis (with calcints in the tissue of membranes of the nephron tubules and in the glomerular epithelium), kidney tumors (carcinoma, nephroma ).
The calcification of pyramids of kidneys detected by ultrasound means the formation of a cluster of calcium salts in the triangular regions of the medulla of the kidney, that is, where the neurons are filtering and forming urine. A parietal calcification in the kidney develops when atrophy or die parenchyma cells - due to pyelonephritis or polycystosis.
When a history of patients has tuberculosis or cytomegalovirus adrenalitis, cystic formation in their brain substance or Addison's disease (destroying this substance), adrenal adrenal cortex, pheochromocytoma, carcinoma or neuroblastoma, adrenal calcification is their "fellow traveler".
He has no symptoms of his own, so that the main signs of adrenal insufficiency are observed: general weakness, dizziness, increased skin pigmentation, poor appetite and weight loss, bowel problems, myalgia, numbness in the skin, increased irritability, etc.
Whatever the causes of calcification of the liver, as in the case with other internal organs, the symptoms of calculous dystrophy will be within the clinical picture in the defeat of hepatocytes. Therefore, there may be digestive disorders (due to decreased production of bile), and weight loss, and pain in the hypochondrium (right), and a bitter belch.
Calcification of the spleen in most cases is atherocalcinosis of the splenic artery, or by partial calcification of the organ of the hamartoma formed in the parenchyma, which does not manifest itself in any way and is detected accidentally.
Calcification of the gallbladder
According to gastroenterologists, calcification of the gallbladder has two main causes: chronic inflammation (cholecystitis) and oncology (carcinoma). In the case of cholecystitis, often accompanied by cholelithiasis, the degree of calcium dystrophy is so high that the walls of the bladder resemble porcelain in hardness and fragility, and physicians even call such a gall bladder porcelain. In this case, patients complain of abdominal pain (after each meal), nausea and vomiting.
Most of the focal calcification of the pancreas develops at the site of damage and death of its acinar cells, which are replaced by fibrous or fat tissue - in the chronic form of pancreatitis. Then pancreatitis is called calcific, but symptoms of chronic pancreatitis appear . If there are cysts or pseudocysts in the pancreas, they can also contain calcinates.
Calcification of the thyroid gland
With an increase in the thyroid gland (goiter), calcification occurs due to the alteration and proliferation of thyrocytes - the cells of its tissue. If the goiter type is colloidal, then with its growth, in connection with the deterioration of tissue trophism, cells die, and necrotic areas become calcified, often with ossification.
Calcification of the thyroid gland for the presence of cysts in it appears only if its size is significant. And then symptoms of goiter in the form of pain in the neck and headaches are noted; sensation of a foreign body in the throat, perspiration and coughing; general weakness and attacks of nausea.
Calcification of lymph nodes
Lymph nodes are scattered throughout the body, and calcification of lymph nodes can be of different localization - with lymphadenitis, lymphocytic leukemia, lymphogranulomatosis, tuberculosis of the lymph nodes .
Lime dystrophy can affect enlarged or inflamed lymph nodes in people with rheumatoid arthritis, scleroderma, vasculitis, Sharpe's syndrome and other systemic collagen infections (congenital and acquired).
In lymph nodes located in the chest, calcifications are formed with pulmonary tuberculosis, chronic pneumoconiosis, sarcoidosis.
Calcification in women
Calcification of the mammary glands, according to some data, shows at a mammogram not less than 10% of women of childbearing age with fibrosis of mammary glands, fibroadenomas and fibrocystic mastopathy, and also at half of those over fifty. More information in the material - Calcinates in the mammary gland .
In a quarter of the examined women, gynecologists identify calcified myomatous nodes - myocyte calcinosis, which gives the same symptoms as the usual myoma: pelvic pressure, frequent urination and constipation, lower abdominal pain and lower back pain, longer and more intense menstruation.
In any pathology of the ovaries - adnexitis, polycystosis and single cysts, malignant cilioepithelial cystoma or carcinoma - there may be calcification of the ovary, the manifestation of which is limited by the symptoms of adnexitis .
A separate problem is calcification during pregnancy. According to clinical studies, in order to minimize the risk of developing nephropathy in pregnant women, accompanied by an increase in blood pressure (pre-eclampsia), the daily intake of calcium preparations from the middle of the second trimester may be 0.3-2 g. However, calcium is needed not only for this, read - Calcium during pregnancy . And its intake by pregnant women who are not threatened with preeclampsia should not exceed 1.2 grams per day (at a dose outside of pregnancy 700-800 mg).
Pregnant women are recommended to take calcium in order to have enough to form the skeleton of the child, and so that the mother's body does not suffer. But thanks to a whole complex of hormones, the body of healthy women during pregnancy adapts to provide the fruit with calcium not due to its release from the bone matrix. Compensatory mechanisms are included: during the gestation of the child, the absorption of this macerelent from foodstuffs increases, the inverse absorption of Ca in the intestine increases, its excretion through the kidneys and blood content decreases, the production of hormones of parathyroid hormone and calcitonin, and also calcitriol increases.
If supplemental intake of calcium preparations disrupts the natural regulation of mineral metabolism, calcification is possible in pregnancy, which affects the excretory system working in an enhanced mode - with the development of nephrocalcinosis.
Not only the future mother may suffer: with excess calcium, the fontanel is closed too early in the body of a newborn, and this increases intracranial pressure and interferes with the normal development of the brain. In children of the first year of life due to the acceleration of ossification (ossification) of porous bone tissue, the process of its replacement by lamellar bone is disrupted, and the growth of the child slows down.
One of the complications of pregnancy is calcification of the placenta, although the accumulation of insoluble calcium salts in the tissues of the maternal side of the mature (mature) placenta is detected in almost half of the cases of a successful pregnancy that is resolved, that is, it can not be considered pathology. In other cases calcifications are formed either because of early maturation of the placenta, or because of endocrine pathology or the presence of risk factors for the development of calcification in the mother.
Calcinates in the immature placenta (before the gestation period of 27-28 weeks) can worsen its blood supply and provoke fetal hypoxia, delay its prenatal development, congenital pathologies and abnormalities, cause premature birth - all depends on the maturity of the placenta and the level of calcareous dystrophy.
In obstetrics, based on the results of ultrasound at the period from the 27th to the 36th week, determine the 1 degree of calcification of the placenta (calcification of the placenta 1 degree) - in the form of individual microcalcinates. Calcium placenta 2 degrees - from 34th to 39th week - means the presence of calcifications, visualized without further increase. And with calcification of the placenta 3 degrees (which is determined from the 36th week), numerous foci of calcareous dystrophy are revealed.
In this case, a special concern is calcification of the placenta 2 degrees at the term of 27-36 weeks or the presence of microcalcinates up to the 27th week of pregnancy.
Calcification in men
Calcium prostate can occur due to hyperplasia, adenoma or adenocarcinoma of the prostate gland, as well as due to its diffuse changes associated with age-related involution. For more details see the material - Diffuse changes in the prostate gland .
Calcitosis of the scrotum - with pain in the groin area - is possible in the chronic form of orchitis, scleroderma, sebaceous gland cysts, after injuries, as well as in elderly men with age-related degeneration of the genital tissues.
Focal or diffuse calcification of the testicles is associated with inflammatory processes of an infectious nature, in particular tuberculosis, epididymitis or phoepididymitis, the presence of teratoma or oncology and may manifest as discomfort in the groin (due to tightening of the testicle structure) and pain attacks.
Calcification in children
Most of the above causes and risk factors for dystrophic calcification cause calcification in children, so specialists pay attention to those diseases that lead to the manifestation of calcification in childhood, sometimes in infants. Such pathologies include:
- Wolman's disease - with diffuse calcifications of both adolescents in newborns;
- congenital toxoplasmosis - causes focal calcification in the cortex, subcortex or brain stem. The surviving children atrophy the optic nerves, develop hydrocephalus and a number of endocrinopathies; they lag behind in development - physical, mental and mental;
- Conrady-Huenermann syndrome or congenital calcific chondrodystrophy, in which calcifications are formed in the articular cartilage of the epiphyses of the tubular bones of the upper and lower extremities;
- congenital idiopathic calcification of arteries;
- Albright's syndrome (localization of Ca deposition - subcutaneous soft tissues, eye mucosa and cornea, muscle tissues, artery walls, myocardium, renal parenchyma);
- the elastic pseudo-dandy Darya (with the formation of self-resolving nodular or plaque-like calcifications of the skin);
- hereditary oxalose, which causes diffuse calcification of the kidneys (calcification consists of calcium oxalate) with severe renal failure and calcification of the joints. The disease progresses and leads to a lag in growth.