Radiographic Manifestation of Cosmetic Hand Rejuvenation With Calcium Hydroxyapatite

Hand rejuvenation procedures using dermal fillers are becoming increasingly popular as patients seek to restore dorsal hand volume and camouflage tendons and veins. Calcium hydroxyapatite is a commonly used filler that is inherently radiopaque and may produce imaging findings that mimic disease. We report the case of a 75-year-old woman who presented for follow-up of radiocarpal arthritis. Although her radiographs confirmed degenerative arthritis, they also demonstrated diffuse, clustered radiopaque foci in the dorsal soft tissues. These findings initially suggested metabolic or dystrophic calcification, but on further history, the patient disclosed recent cosmetic hand rejuvenation with calcium hydroxyapatite filler, establishing the true etiology. To our knowledge, the radiographic appearance of dermal filler in the hand has not been previously described. As the popularity of cosmetic hand rejuvenation continues to increase, both hand surgeons and radiologists should be aware of this phenomenon to prevent misdiagnosis and unnecessary diagnostic work-up.