Soft tissue radiopacities and dystrophic calcifications

Calcification is soft tissues i.e. heterotopic ossification

1. Dystrophic calcification

  • Degenerated, diseased, dead tissue
  • Normal calcium and phosphate levels
  • Localized to site of injury (trauma, infection, inflammation) eg. cysticercosis parasite

a. Chronically inflamed cysts – eg. Residual cyst

b. Calcified lymph nodes

c. Tonsillar calculi (tonsilloliths)

  • Repeated inflammation enlarges tonsillar crypts
  • Incomplete resolution of organic debris (bacteria, pus, epithelial cells, food) – nidus for calcification


d. Arterial calcifications: Arteriosclerosis – calcium deposits (atheromatous plaque) in medial coat of vessel

2. Idiopathic calcification (calcinosis)

  • Deposit calcium in normal tissues
  • Normal calcium and phosphate levels

a. Chondrocalcinosis: Calcium phosphate crystals build up in joints – irritation – inflammation – cartilage damage

b. Sialoliths

c. Phleboliths – intravascular thrombi form due to venous stagnation – mineralize

d. Rhinoliths

e. Antroliths

3. Metastatic calcification

  • Minerals precipitate into normal tissues due to higher than normal calcium levels
  • Bilateral and symmetrical

a. Ossification of stylohyoid ligament

  • Classic eagle syndrome – cranial nerve impingement
  • Carotid artery syndrome – impingement of carotid vessels

b. Osteoma cutis: In skin, acne of long duration, in a scar, chronic inflammatory dermatosis

c. Myositis ossificans

  • Fibrous tissue and heterotrophic bone form in muscles interstitial tissues, tendons and ligaments
    • 1. Localized MO – acute/chronic trauma, heavy muscular strain, in occupation or sports, muscle injury from multiple injections (dental LA)
    • 2. Progressive MO – AD, rare, early infancy, males
  • High calcium levels: Hyperparathyroidism, hypercalcemia, malignancy
  • High phosphate levels: Chronic liver failure