We present the case of a 74-year-old lady with unusual rapidly progressing and extensive interstitial calcinosis. Before onset of calcinosis she was diagnosed with ANA and SCL-70 positive limited cutaneous systemic sclerosis with Raynaud's phenomenon, sclerodactyly, telangiectasia, mild interstitial lung disease and arthritis. In the course of disease she developed a recurrent calcified synovial cyst of the spine and calcifying arthritis of hands and feet unresponsive to immunosuppression with methotrexate, leflunomide, rituximab, colchicine and abatacept. Synovia analysis revealed a predominantly cholesterol rich effusion with only low numbers of inflammatory cells. Further sites of ectopic calcifications were the spine, skin, entheses and arteries. There was no underlying renal insufficiency, hyperparathyroidism, hypercalcaemia or hyperlipidaemia. Differential diagnosis of bone metabolism, rare hereditary disorders, diagnostic work-up and treatment options of calcinosis will be discussed.
Disclosure of Interest None declared