Musculoskeletal Imaging

Milk alkali syndrome

a disorder in which excessive intake of milk and alkali over a long period of time (a few to many years) leads to metastatic calcification. Initially the syndrome was identified in patients with chronic peptic ulcer disease and renal insufficiency, who had hypercalcaemia without hypercalcinuria or hypophosphataemia, normal serum alkaline phosphatase levels, azotaemia, and mild alkalosis. Patients are frequently ingesting calcium carbonate with or without milk for abdominal pain or heartburn. The classic triad of this syndrome consists of hypercalcaemia, alkalosis and renal impairment.

On radiographs amorphous unilateral or bilateral periarticular calcific deposits are seen, along with widespread calcification in blood vessels, kidneys, ligaments and falx cerebri. Bone tissues are normal. Also, see chemical agents (III:1), Fig. 2.

DR