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November 28, 1977

Subcutaneous Ossification

JAMA. 1977;238(22):2366. doi:10.1001/jama.1977.03280230030006

To the Editor.—  The calcific densities shown in the article by Strauss and Harari (238:431-432, 1977) appear to represent subcutaneous ossification (SO). Histologic examination in such cases discloses cancellous bone and no primary calcification, apparently the result of fat metaplasia.1-4The condition, described around the middle of the last century, was recognized in 1957 to be a manifestation of chronic venous insufficiency.1 Being aware of the condition, we have since identified one new, usually less extensive case nearly every week in our peripheral vascular clinic. We have followed more than 500 such cases in the past 20 years and stopped about ten years ago to keep a record of new cases. Proper diagnosis is of interest to the physician dealing with patients who suffer from venous disorders.Ulcerations are common, often respond only with delay to compression treatment, and tend to recur. Occasionally, removal of an underlying bone