Metastatic Calcification and Dystrophic Calcification

By Dr Arun Pal Singh

Metastatic calcification and dystrophic calcification are pathological calcification which means abnormal calcium deposits at the places where these are normally not found.

Heterotopic ossification is another name for pathologic calcification and both metastatic and dystrophic calcification constitute heterotopic calcification.

Normally, inorganic calcium salts are found in bones and teeth.

Pathologic or heterotopic calcification is the deposition of calcium salts in tissue other than osteoid [bone] and enamel [teeth]

Here are the details of these types of calcification

Metastatic Calcification

In this type of calcification, the tissue being affected is normal but the main defect is an elevated blood calcium level. Elevated calcium causes deposition of the calcium in tissues and results in the removal of calcium from the bones.

This type of calcium deposition occurs in a variety of sites like kidneys, lungs, stomach, blood vessels, cornea.

Causes of Metastatic Calcification

Chronic Renal Failure [causes secondary hyperparathryoidism]
Hyperparathyroidism
- Primary Hyperparathyroidism
- Secondary Hyperparathyroidism
Excessive absorption of calcium from the bowel
- Hypervitaminosis D
- Idiopathic hypercalcemia of infancy
Hypophosphatasia
Malignancies
- Parathyroid adenoma [causes primary hyperparathyroidism]
- Multiple myeloma
- Lymphoma
- Leukemia
- Hypopharyngeal squamous cell carcinoma
- Synovial sarcoma
- Breast carcinoma
- Choriocarcinoma
Destructive bone lesions
Renal tubular acidosis
Mechanism of metastatic calcification

The mechanism of metastatic calcification is not clear.

Metastatic calcification can be influenced by the release of excess calcium salts from the bone. Phosphate concentration, alkaline phosphatase activity, and alkaline environment may contribute.

This leads to precipitation of The calcium phosphate and calcium carbonate salts in tissues.

Metastatic calcification occurs when there is hypercalcemia but it doesn’t happen in all cases of hypercalcemia.

Dystrophic Calcification

In dystrophic calcification, serum calcium levels are normal and the calcium salts are deposited in dead or degenerate tissues.

Mechanism of Dystrophic Calcification

The process of dystrophic calcification starts in membrane-bound vesicles within cells. When the membrane gets damaged, calcium binds to the phospholipid in the membrane. Phosphatases within the membrane add phosphate groups to the calcium, forming calcium phosphate which is the hydroxyapatite crystals in the regular bone.

Examples of Dystrophic Calcification

Following are examples of dystrophic calcification

Calcification of caseous tissue in tuberculosis
After fat necrosis in the breast or pancreatitis
Calcification in thrombus such as left ventricular thrombus, coronary artery calcification, inferior vena cava, superior vena cava
Hemorrhagic infarction in the spleen
Calcified hematoma
Myositis ossificans
Atherosclerotic plaques
Granulation tissue in chronic inflammation like constrictive pericarditis
Monckeberg’s sclerosis – A form of arteriosclerosis
Infection as in Schistosomiasis [Leads to calcification of the ureters, bladder, and seminal vesicles
Degenerate colloid goiter
Calcification in various types of cyst
Calcinosis Cutis
Degenerate tumor-like uterine leiomyoma

Spread the Knowledge

About Dr Arun Pal Singh

Arun Pal Singh is an orthopedic and trauma surgeon, founder and chief editor of this website. He works in Kanwar Bone and Spine Clinic, Dasuya, Hoshiarpur, Punjab.

This website is an effort to educate and support people and medical personnel on orthopedic issues and musculoskeletal health.

You can follow him on Facebook, Linkedin and Twitter

Iliopsoas Bursitis – Causes, Symptoms and Treatment

Iliopsoas bursitis is an uncommon cause of anterior hip pain and is due to inflammation of iliopsoas bursa or iliopectineal bursa. Because of the rarity of occurrence and nonspecific presentation, the diagnosis of iliopsoas bursitis is may be overlooked. Relevant Anatomy The iliopsoas bursa or iliopectineal bursa is the largest one in the body. It […]

Tendon Transfer Principles

Tendon transfer is used to replace the deficient motor unit and to restore function. The functional loss may occur secondary to tendon rupture, peripheral nerve injury, plexus injury or other neuropathies. In tendon transfer, a healthy functional tendon to be transferred is transected then transferred to another tendon or bone to restore function. The neurovascular […]

Spine Injuries – Presentation, Imaging and Treatment

Spine injuries are most commonly caused by motor vehicle injuries followed by fall and gunshot injury. Most of the spine injuries occur in cervical spine followed by thoracic and lumbar. Injuries of the cervical spine occur in more than half of all spine injuries in trauma patients. Most isolated thoracic and lumbar spine injuries are […]

Spinal Cord Injury Levels

Spinal cord injury levels can be expressed in many ways and it is important to understand the correlations. This has an important bearing in marking the level of injury and correlating with the anatomy. For example, if an injury occurs at T10-11 vertebral level, it is going to damage her lower thoracic as well as […]

Complications of Cervical Spine Surgery

Complications of cervical spine surgery are in immediate postoperative period or delayed and some of the complications of cervical spine surgery are restricted to approach only. Early [Postoperative] Complications Neurologic Deficit Neurological deficit is the most devastating complication of spine surgery. The cause could be an intraoperative event such as a direct spinal cord […]

Fingertip Injuries of The Hand

Fingertip injuries can be crushing, tearing, or amputating injuries to the tips of fingers and thumbs. Injury can include damage to skin and soft tissue, bone (distal phalanx), or to the nail and nailbed. The tips of longer fingers tend to be injured more . Classification of Fingertip Injuries of The Hand Mostly used classification […]

Poland Syndrome – Presentation and Treatment

Poland Syndrome is a congenital condition characterized by the absence of chest wall muscles on one side of the body and short, webbed fingers of the limb of the same side. The Poland syndrome is also known as Poland Anomaly, Poland Sequence, and Poland Syndactyly. Relevant Anatomy The pectoralis major is a large muscle of […]