case_images: PMC9477477_01
case_images: Multiple ulcers on the mid-distal third of the left leg, with diameters varying from 1.0 to 2.5 cm, with moderate exudate and presence of spontaneous extrusion of fragmented, stony, white material, but free from signs of secondary infection. Dressed with calcium alginate and sodium.
case_images: jvb-21-e20210166-g01-en.jpg
case_images: PMC9477477_01_jvb-21-e20210166-g01-en.jpg
case_images: gf0100
case_images: The patient also had edema 2+/4+, lipodermatosclerosis, lymphatic vesicles, multiple ulcerous lesions of the mid-distal third of the left leg, with diameters varying from 1.0 to 2.5 cm, moderate exudate, no signs of secondary infection, and presence of spontaneous exudate of fragmented, stony, white-colored material (Figure 1).
case_images: Simple X-rays of the lower limbs: lesions compatible with amorphous calcifications of soft tissues of the external aspect of the mid and lower third of the legs.
case_images: jvb-21-e20210166-g02-en.jpg
case_images: PMC9477477_01_jvb-21-e20210166-g02-en.jpg
case_images: gf0200
case_images: (A) and (B) Color Doppler ultrasound of the lower limbs (B-mode) with hyperechogenic images that generate intense acoustic shadows, with areas of convergence, suggestive of calcium deposits in the subcutaneous cellular tissues, in the mid-distal third of the leg in the region of the ulcers.
case_images: jvb-21-e20210166-g03-en.jpg
case_images: PMC9477477_01_jvb-21-e20210166-g03-en.jpg
case_images: gf0300
case_images: Doppler ultrasound (CDUS) of the lower limbs revealed reflux in the left great saphenous vein and ruled out signs of acute or previous deep vein thrombosis. During B-mode scanning of the subcutaneous level, hyperechogenic images were observed, generating intense sonic shadows with areas of confluence, suggestive of calcium deposits in the SCT of the distal mid third of the leg, in the region of the ulcers (Figures 3A and 3B).
case_images: A) Computed tomography of the lower limbs (transverse and longitudinal slices) showing diffuse calcium deposits distributed concentrically around the mid and distal thirds of both lower limbs, with no deposits present in other regions of the body.
case_images: jvb-21-e20210166-g04-en.jpg
case_images: PMC9477477_01_jvb-21-e20210166-g04-en.jpg
case_images: gf0400
case_images: Computed tomography of the lower limbs showed diffuse calcium deposits with a concentric distribution in the mid and distal thirds of both lower limbs, with no deposits in other areas of the body (Figures 4A and 4B).