Calciphylaxis in a patient with end-stage renal disease: Multimodality imaging and clinical correlation

Calciphylaxis, also known as calcific uremic arteriolopathy, is a rare and life-threatening disorder that typically affects patients with end-stage renal disease (ESRD) on dialysis. It is characterized by calcification of small to medium-sized blood vessels in the dermis and subcutaneous tissues, leading to painful nodules, skin necrosis, and a high mortality rate. We present the case of a 40-year-old woman with ESRD and type 2 diabetes mellitus who developed painful subcutaneous nodules on her lower extremities. Radiographs revealed a fine reticular and confluent pattern of subcutaneous calcifications, while computed tomography (CT) provided detailed visualization of extensive calcific deposits within the soft tissues and musculature. Clinical photographs captured the dermatologic evolution from early plaques to extensive skin ulceration. This case underscores the importance of early radiologic diagnosis and multimodality imaging in guiding timely intervention for calciphylaxis.