Physical examination. On physical examination, the man was found to have firm, fixed, nontender nodules on the right elbow and bilateral metacarpal joints. Pain was elicited in the right elbow on passive range of motion. On admission, laboratory test findings were notable for hypercalcemia (12 mg/dL) and hyperphosphatemia (7.4 mg/dL). Parathyroid hormone and vitamin D levels were normal. A radiograph of his right elbow revealed multilobular periarticular calcinosis (Figure 1). A computed tomography scan of the right elbow revealed multiple lobular structures with sedimentation, but without associated osseous erosion or destruction (Figure 2).
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