A 46-year-old man receiving chronic hemodialysis for polycystic kidney disease is admitted to the hospital with new-onset dyspnea and altered sensorium. He is noted to have “milky” secretions draining from a spontaneous eruption on his left thigh (Figure 1A). His thigh is swollen; radiographs show bulky, extra-articular calcifications (Figure 1B). A 3.4 × 2.3-cm mass involving the posterior mitral leaflet associated with moderate regurgitation is found with transesophageal echocardiography.
Patel SM, Miller TD. Diffuse Calcification and a Draining Wound. JAMA. 2013;309(2):181–182. doi:10.1001/jama.2012.91090
Customize your JAMA Network experience by selecting one or more topics from the list below.