A 58-year-old woman with chronic kidney disease on hemodialysis develops widespread calcification of the media of muscular arteries, including radial and tibial vessels, visible on plain radiograph. Serum calcium and phosphate are markedly elevated. Serum lipids are normal. Which term best describes this vascular pathology?

• A Atherosclerosis
• B Hyaline arteriolosclerosis
• C Mönckeberg medial calcific sclerosis ✓
• D Phlebosclerosis

Explanation

Mönckeberg medial calcific sclerosis is dystrophic calcification of the media of medium-sized muscular arteries, classically seen in elderly patients and those with chronic kidney disease. It is non-occlusive, does not involve the intima, and is not an atherosclerotic process. The calcification appears as a pipe-stem pattern on imaging. Unlike atherosclerosis, there is no lipid deposition or inflammatory plaque formation in the intima. Hyaline arteriolosclerosis affects small arterioles and is linked to hypertension or diabetes. This distinction is frequently tested.

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

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.