Sheeza Basharatover 1 year ago

Mönckeberg's sclerosis

It is a degenerative and apparently non-inflammatory disease in which the media of small and medium-sized muscular arteries becomes calcified independently of atherosclerosis. ⠀ ⠀ ⏩It does not involve primarily the intimal layer of the artery, the lumen is kept open by the rigid media and, therefore, luminal narrowing is not a direct consequence.⠀ ⠀ ⏩It is more common in people over 50 years of age and is commonly found in the peripheral arteries causing “pipestem” arteries. It can easily be seen as an opaque vessel on normal X-rays and purple material on histologic slides⠀ ⠀ ⏩The result is progressive stiffening of the elastic layer of the arterial wall. This loss of elasticity can subsequently lead to systolic hypertension, left ventricular hypertrophy and impaired myocardial perfusion and ultimately increases risk of cardiovascular diseases.⠀ ⠀ ⏩The exact etiopathogenesis of this process is not clear but is frequently related to glucose intolerance, aging, male gender, autonomic neuropathy, osteoporosis and, chronic renal failure.⠀ ⠀ ⏩It has also been associated with autonomic neuropathy in diabetics, suggesting that autonomic dysfunction might play an important role in medial calcification.⠀ ⠀ ⏩Abnormal vascular smooth muscle cells with osteoblastic properties, and cytokine modulators of bone mineralisation such as osteoprotegerin, TNF-related apoptosis-inducing ligand and receptor activator of nuclear factor kappa B ligand.⠀ ⠀ ⏩It commonly occurs in peripheral arteries of the lower limbs where it is seen as "rail tracking" on incidental plain radiographs.⠀ ⠀ ✅Lower limb arteries show early calcification