Caseous annular calcification most commonly affects which annulus?

Caseous annular calcification most commonly affects which annulus?

• A. Anterior annulus
• B. Posterior annulus
• C. Septal annulus
• D. Lateral annulus

Answer: (B)

Caseous annular calcification is a rare form of mitral annular calcification that most frequently involves the posterior mitral annulus. The posterior portion of the mitral ring is where calcific degeneration commonly concentrates, so this variant shows up here more than elsewhere. On imaging you’ll often see a heavily calcified posterior annulus with a central liquefactive or echolucent area, which helps distinguish it from other masses or infections that can appear near the valve. The other annular regions—the anterior, septal, or lateral—are not the typical sites for this condition, making the posterior location the hallmark.

Caseous annular calcification is a rare form of mitral annular calcification that most frequently involves the posterior mitral annulus. The posterior portion of the mitral ring is where calcific degeneration commonly concentrates, so this variant shows up here more than elsewhere. On imaging you’ll often see a heavily calcified posterior annulus with a central liquefactive or echolucent area, which helps distinguish it from other masses or infections that can appear near the valve. The other annular regions—the anterior, septal, or lateral—are not the typical sites for this condition, making the posterior location the hallmark.