A 62-year-old hypertensive woman has hard, tortuous, pipe-like radial arteries that are easily palpable but show no reduction in pulse volume. Radiographs of the forearm reveal ring-like linear calcifications along the vessel walls. Biopsy shows calcium deposits confined to the media of a muscular artery with an intact internal elastic lamina and no intimal thickening. What is the diagnosis?

• A Calcific aortic stenosis with extension into coronaries
• B Monckeberg medial calcific sclerosis ✓
• C Advanced intimal atherosclerosis of the radial artery
• D Pseudohypoparathyroidism with metastatic calcification

Explanation

Monckeberg medial calcific sclerosis is calcification of the media of muscular arteries, typically in persons over 50 years, often with diabetes or chronic kidney disease. It produces rigid, palpable, pipe-like vessels and radiographic ring-like calcification, but it does not narrow the lumen and is not itself clinically significant. Intimal atherosclerosis would show fibrofatty intimal thickening with luminal compromise. Metastatic calcification affects multiple tissues due to calcium-phosphate imbalance rather than being confined to the arterial media.

Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.

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Written and medically reviewed by the StethoPrep medical team.