Verkalkungen

Verkalkungen (calcifications) are deposits of calcium salts in soft tissues, organs, or body fluids. They appear as dense, radiopaque foci on imaging and can be incidental findings or part of disease processes. Calcifications can arise from aging, inflammation, infection, or metabolic disturbances.

Two major pathophysiological patterns are recognized. Dystrophic calcification occurs in damaged or necrotic tissue despite normal systemic calcium and phosphate levels. Metastatic calcification results from elevated calcium or phosphate levels (hypercalcemia, hyperphosphatemia) and can deposit in otherwise normal tissues, often in the lungs, kidneys, stomach, and vasculature.

Common locations include vascular and valvular structures (arterial wall calcifications, aortic and mitral valve calcification), the kidneys (nephrocalcinosis, stones), the breast (calcifications seen on mammography with patterns classified as benign or suspicious), and the brain or pineal region. In dentistry, mineralization of dental plaque forms dental calculus, contributing to periodontal disease.

Diagnosis and interpretation rely on imaging characteristics and clinical context. Ultrasonography, CT, and mammography have different sensitivity for various calcifications. Some patterns are benign; others require further investigation, such as suspicious breast microcalcifications that prompt biopsy or vascular calcifications that reflect underlying atherosclerosis.

Management focuses on the underlying cause and symptoms. Metastatic calcifications are addressed by correcting calcium-phosphate metabolism, while dystrophic calcifications may require treatment if they impair function or cause pain. Dental calculus is removed by professional cleaning and improved oral hygiene.