[Calcic tenosynovitis in a patient with undifferentiated connective tissue disease].

1699-258X/$ see front matter © 2010 Elsevier España, S.L. All rights reserved. We present the case of a 50 year old woman who was diagnosed with undifferentiated connective tissue disease (UCTD), based on severe Raynaud’s phenomenon with ischemic ulcers, extensive calcinosis, sclerodactilia, polyarthritis, glomerulonephritis, polyserositis, chronic hypertransaminasemia and had undergone the bilateral suprachondyleal amputation with severe acute ischemia (associated to antiphospholipid syndrome and structural vasculopathy due to the disease). She was positive to anti-MI2 and anti-Ro52, AMA with a titer of 1:640, with negative ANA, anti-DNA, anti-U1RNP, anti-SCL70, anti-LKM and ANCA. The patient was clinically stable under treatment with steroids, antimalarials, cumarin and cyclic intravenous iloprost. The patient had complained of chronic, painless swelling on both sides of the wrists, with little functional limitation, clinically compatible with flexor and extensor tenosynovitis. The ecography (Logic 9 series, General Electric) showed distension of the common extensor tendon sheaths of the fingers, common flexor tendons and first finger flexor (Figure), with an associated power-Doppler signal, with multiple hyperecogenicimages on the sheaths and subcutaneous tissue, with posterior sonic shadow, compatible with hydroxiapatite calcium deposits (in the context of the patients’ calcinosis). Hand x rays also showed multiple calcifications on soft tissue of the wrist and fingers, without being able to determine the localization of the deposits. A guided infiltration with triamcinolone was performed with an excellent clinical response.