Imaging assessment of calcinosis in juvenile dermatomyositis: a narrative review

Belina Y Yi¹, Jessica Perfetto², Evin Rothschild³, Kelly Rouster-Stevens⁴, Amanda Robinson⁵, Kathryn Cook⁶, Delaney D Ding⁷, Andrea Eagle Child⁸, Ovgu Kul Cinar⁹, Barbara Limbach¹⁰, Charalampia Papadopoulou⁹, Lesley Ann Saketkoo¹¹, Adam Schiffenbauer¹², Heinrike Schmeling¹³, Antonia Valenzuela¹⁴, Susan Shenoi¹⁵, Dawn M Wahezi¹⁶; CARRA JDM Calcinosis workgroup

Affiliations

¹ Johns Hopkins University School of Medicine, Baltimore, MD, USA. byi4@jh.edu.
² Hassenfeld Children's Hospital at NYU Langone, New York, NY, USA.
³ Johns Hopkins University School of Medicine, Baltimore, MD, USA.
⁴ Emory University, Children's Healthcare of Atlanta, Atlanta, GA, USA.
⁵ University of Utah, Salt Lake City, UT, USA.
⁶ Akron Children's Hospital, Akron, OH, USA.
⁷ University of Florida College of Medicine, Gainesville, FL, USA.
⁸ Childhood Arthritis and Rheumatology Research Alliance (CARRA), Calgary, AB, Canada.
⁹ Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.
¹⁰ Cure JM, Childhood Arthritis and Rheumatology Research Alliance (CARRA), Wolcottville, IN, USA.
¹¹ New Orleans Scleroderma and Sarcoidosis Patient Care and Research Center, Louisiana State University and Tulane University Medical Schools, New Orleans, LA, USA.
¹² National Institute of Environmental Health Sciences (NIEHS), National Institutes of Health (NIH), Bethesda, MD, USA.
¹³ Section of Rheumatology, Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
¹⁴ Department of Clinical Immunology and Rheumatology, Pontificia Universidad Católica de Chile, Santiago, Chile.
¹⁵ Seattle Children's Hospital and Research Center, University of Washington, Seattle, USA.
¹⁶ Children's Hospital at Montefiore, Bronx, NY, USA.

PMID: 40281557
PMCID: PMC12032750
DOI: 10.1186/s12969-025-01098-z

Review

Imaging assessment of calcinosis in juvenile dermatomyositis: a narrative review

Belina Y Yi et al. Pediatr Rheumatol Online J. 2025.

. 2025 Apr 25;23(1):44.

doi: 10.1186/s12969-025-01098-z.

Authors

Affiliations

¹ Johns Hopkins University School of Medicine, Baltimore, MD, USA. byi4@jh.edu.
² Hassenfeld Children's Hospital at NYU Langone, New York, NY, USA.
³ Johns Hopkins University School of Medicine, Baltimore, MD, USA.
⁴ Emory University, Children's Healthcare of Atlanta, Atlanta, GA, USA.
⁵ University of Utah, Salt Lake City, UT, USA.
⁶ Akron Children's Hospital, Akron, OH, USA.
⁷ University of Florida College of Medicine, Gainesville, FL, USA.
⁸ Childhood Arthritis and Rheumatology Research Alliance (CARRA), Calgary, AB, Canada.
⁹ Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.
¹⁰ Cure JM, Childhood Arthritis and Rheumatology Research Alliance (CARRA), Wolcottville, IN, USA.
¹¹ New Orleans Scleroderma and Sarcoidosis Patient Care and Research Center, Louisiana State University and Tulane University Medical Schools, New Orleans, LA, USA.
¹² National Institute of Environmental Health Sciences (NIEHS), National Institutes of Health (NIH), Bethesda, MD, USA.
¹³ Section of Rheumatology, Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
¹⁴ Department of Clinical Immunology and Rheumatology, Pontificia Universidad Católica de Chile, Santiago, Chile.
¹⁵ Seattle Children's Hospital and Research Center, University of Washington, Seattle, USA.
¹⁶ Children's Hospital at Montefiore, Bronx, NY, USA.

PMID: 40281557
PMCID: PMC12032750
DOI: 10.1186/s12969-025-01098-z

Abstract

Calcinosis is a severe manifestation of juvenile and adult idiopathic inflammatory myopathies, which can lead to pain, limited range of motion, disfigurement, and infection. It is more common in juvenile idiopathic inflammatory myopathies, especially in juvenile dermatomyositis (JDM). Calcinosis can be visible on cutaneous surfaces, although can also present in muscles and internal organs, making a thorough assessment difficult without imaging modalities. In this narrative review, we discuss different imaging modalities used in evaluating JDM-associated calcinosis including X-ray, computed tomography (CT), magnetic resonance imaging (MRI), and ultrasound (US).

Keywords: Calcinosis; Computed tomography; Idiopathic inflammatory myopathy; Juvenile dermatomyositis; Magnetic resonance imaging; Ultrasound; x-ray.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: Not applicable. Consent for publication: Consents for publication were obtained. Competing interests: The authors declare no competing interests.

Figures

**Fig. 1**
X-ray of abdomen and left knee with extensive amorphous and multilobulated calcinosis in a 7-year-old female with refractory JDM

**Fig. 2**
Low-dose whole body CT of a 7-year-old female with refractory JDM and extensive calcinosis universalis. Arrows demonstrate prominent locations of the extensive calcifications in the soft tissues and musculature extending from the neck, along the torso, upper and lower extremities. Also demonstrated are intra-abdominal and pelvic calcifications

**Fig. 3**
US of left arm with evidence of focal area of hyperechogenicity with posterior acoustic shadowing consistent with subcutaneous calcinosis in a 7-year-old female with refractory JDM

**Fig. 4**
Coronal T2 STIR MRI with multiple areas of hypointensive signal corresponding to extensive lobular subcutaneous calcinosis in a 12-year-old female with juvenile dermatomyositis

See this image and copyright information in PMC

References

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Imaging assessment of calcinosis in juvenile dermatomyositis: a narrative review

Affiliations

Imaging assessment of calcinosis in juvenile dermatomyositis: a narrative review

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

Publication types

MeSH terms

LinkOut - more resources

Full Text Sources