scholarly journals Cervical vertebrae affection in calcium pyrophosphate crystal deposition disease (description of a clinical case)

2021 ◽  
Vol 15 (5) ◽  
pp. 85-88
Author(s):  
E. V. Cheremushkina ◽  
M. S. Eliseev ◽  
O. V. Zhelyabina
Keyword(s):  
Cervical Vertebrae ◽  
Clinical Manifestations ◽  
Axial Skeleton ◽  
Calcium Pyrophosphate ◽  
Pathological Process ◽  
Crystal Deposition ◽  
Calcium Pyrophosphate Deposition Disease ◽  
Deposition Disease ◽  
Chronic Arthropathy ◽  
Bone Structures

Calcium pyrophosphate deposition disease (CPPD) is characterized by polymorphism of clinical manifestations: from asymptomatic course to severe chronic arthropathy with destruction of bone structures. It is believed that calcium pyrophosphate crystals are more often found in the knee and so-called root joints (hip and shoulder), as well as in the triangular fibro-cartilaginous complex. However, CPPD can also affect the axial skeleton. A pathological process localized in the spine is more common in older people and is rare at a young age. The article presents a case of chondrocalcinosis of the cervical spine in a 62-year-old female patient who did not have risk factors.

scholarly journals THE CLINICAL MANIFESTATIONS OF CALCIUM PYROPHOSPHATE CRYSTAL DEPOSITION DISEASE

2014 ◽  
Vol 0 (4) ◽  
pp. 405 ◽  
Author(s):  
F. M. Kudaeva ◽  
S. A. Vladimirov ◽  
M. S. Eliseev ◽  
A. V. Volkov ◽  
M. V. Severinova ◽  
...  
Keyword(s):  
Clinical Manifestations ◽  
Calcium Pyrophosphate ◽  
Crystal Deposition ◽  
Crystal Deposition Disease ◽  
Deposition Disease

A very rare benign tumour in the parotid region: calcium pyrophosphate dihydrate crystal deposition disease

2001 ◽  
Vol 115 (6) ◽  
pp. 504-506 ◽  
Author(s):  
Helle Birgitte Dahl Olin ◽  
Kaj Pedersen ◽  
Dorthe Francis ◽  
Hanne Hansen ◽  
Finn Willy Poulsen
Keyword(s):  
Clinical Manifestations ◽  
Neck Region ◽  
Inflammatory Cells ◽  
Calcium Pyrophosphate ◽  
Calcium Pyrophosphate Dihydrate ◽  
Body Type ◽  
Crystal Deposition ◽  
Crystal Deposition Disease ◽  
Deposition Disease ◽  
Pyrophosphate Dihydrate

Calcium pyrophosphate dihydrate crystal deposition disease, exhibits several clinical manifestations, from absence of symptoms to severely destructive arthropathy or conditions simulating neoplasm, which is frequently related to the temporomandibular joint. Fifteen of the 31 reported cases of tophaceous pseudogout were found in the head and neck region. A patient presented with a parotid swelling, which initially was suspected to be malignant because of the following findings: radiodensity, progression into the joint, osseous destruction of the major ala of the sphenoid and a fine needle aspirate with crystals, osteoblasts, megakaryocytes and irregular cells of varying size. At surgery there was found a tumour consisting of a white, firm gritty material. It progressed to the skull base where material had to be left, because of the presence of the nerves and vessels. A frozen specimen was reported to be benign. Histological examination showed inflammatory cells, macrophages, a chondroid material with embedded metaplastic chondroid cells and giant cells of foreign body type. Crystal examination of X-ray diffraction revealed calcium pyrophosphate dihydrate.

scholarly journals OP0205 ULTRASOUND-DETECTED CALCIUM PYROPHOSPHATE CRYSTAL DEPOSITION: WHICH SITES SHOULD BE SCANNED?

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 123.2-124
Author(s):  
E. Cipolletta ◽  
J. DI Battista ◽  
W. Grassi ◽  
E. Filippucci
Keyword(s):  
Sensitivity And Specificity ◽  
Lateral Meniscus ◽  
Diagnostic Value ◽  
Calcium Pyrophosphate ◽  
Crystal Deposition ◽  
Calcium Pyrophosphate Deposition Disease ◽  
Deposition Disease ◽  
Us Findings ◽  
Femoral Condyles ◽  
Age And Sex

Background:In recent years, ultrasonography (US) has emerged as an accurate and reliable tool for the diagnosis of calcium pyrophosphate (CPP) deposition disease (CPPD) in daily practice. Previous studies analyzed the diagnostic value of US findings in different tissues and joints. However, no studies have investigated the optimal US scanning protocol in the diagnosis of CPPD at patient level.Objectives:To assess the diagnostic value of the combinations of OMERACT-defined US findings of CPPD in the upper and lower limbs and to select the best minimal combination of anatomic structures to be scanned for diagnosing CPPD in inter-critical periods.Methods:Patients with a crystal-proven diagnosis of CPPD and age- and sex-matched disease-controls were prospectively enrolled in this cross-sectional, monocentric, case-control study. All subjects underwent a bilateral US examination of 9 hyaline cartilages (HC), 6 fibrocartilages (FC), 5 tendons, 1 joint recess and 1 ligament as follows: shoulder (glenoid FC, humeral HC and acromioclavicular FC), elbow (humeral HC and triceps tendon), wrist (triangular FC, scapho-lunate ligament, volar recess of the radio-lunate joint), hand (HC of the metacarpophalangeal joints from 2nd to 5th finger), hip (acetabular FC and femoral HC), knee (femoral condyles’ HC, meniscal FC, patellar and quadriceps tendons), ankle (talar HC, Achilles tendon and plantar fascia). US assessment was carried-out by a rheumatologist blinded to clinical data. CPP deposits were identified as presence/absence, according to the OMERACT definitions [1].Results:Ninety-five patients were enrolled: 45 CPPD patients (age: 72±10.6 years, disease duration: 5.6±7.8 years, female/male ratio: 1.3) and 50 age- and sex-matched disease-controls (18 with rheumatoid arthritis, 13 with osteoarthritis, 10 with psoriatic arthritis and 9 with gout).The FC of the medial and lateral meniscus were the most frequently involved targets of CPP deposits in cases (81.8% and 77.3% of patients, respectively), followed by the triangular FC of the wrist (68.2%), the HC of the femoral condyles (54.5%), the scapho-lunate ligament (52.3%) and the acetabular FC (50.0%). In all these anatomical targets, US findings indicative of CPP deposits were detected in a significantly higher percentage of cases than controls (p<0.01).The US scanning protocols that showed the best balance between sensitivity and specificity, the most sensitive and the most specific were shown in Table 1.Table 1.Diagnostic performances of different US scanning protocolsAnatomical targetsSESPLH+LH-Knee meniscal FC and wrist triangular FC0.86(0.76-0.96)0.86(0.73-0.94)6.35(3.17-12.72)0.13(0.06-0.30)Knee meniscal FC, wrist triangular FC and hip acetabular FC0.93(0.82-0.99)0.82(0.69-0.91)5.19(2.85-9.42)0.08(0.03-0.24)Hip acetabular FC, knee femoral condyles’ HC andwrist scapho-lunate ligament0.67(0.51-0.80)0.96(0.86-0.99)16.67(4.22-65.82)0.35(0.23-0.53)LH: likelihood ratio, SE: sensitivity, SP: specificity, US: ultrasonography.In all US scanning protocols, each anatomical target was assessed bilaterally.Figure 1 includes representative pictures showing CPP crystal deposits in different anatomical targets.A: Wrist, longitudinal scan of the triangular FC complex.B: Knee, longitudinal scan of the lateral meniscus.C: Hip, longitudinal scan of the acetabular labrum FC,D: Knee, longitudinal scan of the medial femoral condyle’s HC.Arrows: CPP crystal deposits at FC, arrowhead: CPP crystal deposits at HC.Conclusion:Our results suggest that bilateral US assessment of knee, wrist and hip provided acceptable sensitivity and specificity for diagnosing CPPD.References:[1]Filippou G, et al. Identification of calcium pyrophosphate deposition disease (CPPD) by ultrasound: reliability of the OMERACT definitions in an extended set of joints-an international multiobserver study by the OMERACT Calcium Pyrophosphate Deposition Disease Ultrasound Subtask Force. Ann Rheum Dis. 2018;77:1194-9.Disclosure of Interests:Edoardo Cipolletta: None declared, Jacopo Di Battista: None declared, Walter Grassi Speakers bureau: Walter Grassi has received speaking fees from AbbVie, Celgene, Grünenthal, Pfizer and Union Chimique Belge Pharma., Emilio Filippucci Speakers bureau: Emilio Filippucci. has received speaking fees from AbbVie, Bristol-Myers Squibb, Janssen-Cilag, Novartis, Pfizer, Roche and Union Chimique Belge Pharma.

Case Report: Calcium Pyrophosphate Deposition Disease of the TMJ

Skull Base ◽  
2011 ◽  
Vol 21 (S 01) ◽  
Author(s):  
Vasisht Srinivasan ◽  
Andrew Wensel ◽  
Paul Dutcher ◽  
Shawn Newlands ◽  
Mahlon Johnson ◽  
...  
Keyword(s):  
Case Report ◽  
Calcium Pyrophosphate ◽  
Calcium Pyrophosphate Deposition Disease ◽  
Deposition Disease

scholarly journals SAT0554 SONOGRAPHIC ASSESSMENT OF CALCIUM PYROPHOSPHATE DEPOSITION DISEASE AT WRIST. A FOCUS ON THE SCAPHO-LUNATE LIGAMENT.

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1234.2-1235
Author(s):  
E. Cipolletta ◽  
G. Smerilli ◽  
R. Mashadi Mirza ◽  
A. DI Matteo ◽  
F. Salaffi ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Diagnostic Accuracy ◽  
Imaging Techniques ◽  
Calcium Pyrophosphate ◽  
Scaphoid Bone ◽  
Lunate Bone ◽  
Calcium Pyrophosphate Deposition Disease ◽  
Dorsal Aspect ◽  
Deposition Disease ◽  
Extensor Compartment

Background:Only few articles evaluated the wrist in calcium pyrophosphate deposition disease (CPPD), although it is the second most frequent target of CPPD. Very recently, in a computed tomography (CT) study ligamentous calcifications were reported as a highly specific feature of CPPD at wrist level (1).Objectives:i) to determine the prevalence and distribution of the ultrasound (US) findings indicative of calcium pyrophosphate (CPP) crystal deposits at the wrist, with a particular focus on the dorsal aspect of the scapho-lunate ligament (SLL); ii) to investigate the diagnostic accuracy of US and conventional radiography (CR) in the evaluation of CPP crystal deposits at wrist level, iv) to assess the agreement between the different imaging techniques.Methods:Consecutive patients with a “definite” diagnosis of CPPD according to the Ryan and McCarty criteria and disease controls were prospectively included in this cross-sectional single-centre study. Dorsal part of the SLL, triangular fibrocartilage complex (TFCC), and volar recess of the radio-lunate joint were explored using US (according to EULAR standard scans and OMERACT definitions), CR and CT.Results:Sixty-one CPPD patients and 39 disease controls were enrolled. Two-hundred wrists were evaluated using both CR and US. CT data of 26 (13.0%) wrists were available: 20 wrists in CPPD patients and 6 wrists in controls. CPP crystal deposits were found by US in at least one wrist in 95.1% of CPPD patients and in 15.4% of controls (p<0.001). SLL calcification was reported in 83.6% of CPPD patients and in 5.1% of controls (p<0.001). CPP crystal deposits were observed by US at the SLL and/or radio-lunate joint in 5.7% of wrists and 6.6% of CPPD patients, but not at the TFCC of the same wrist. On CR, calcifications were found in at least one wrist in 72.1% of CPPD patients and in 0% of controls (p<0.001). Using the Ryan-McCarty criteria as a gold standard, the sensitivity, specificity and diagnostic accuracy were 0.72 (0.59-0.83), 1.0 (0.91-1.0) and 0.83 (0.74-0.90) for CR and 0.95 (0.86-0.99), 0.85 (0.69-0.94) and 0.91 (0.84-0.96) for US. Table 1 shows the agreement between the different imaging techniques.Tabel 1.Agreement between US and the other imaging techniques in the evaluation of CPP crystal deposits at the wrist.US-CR (n=200)US-CT (n=26)TFCC0.55 (0.43-0.67)0.70 (0.43-0.97)SLL0.23 (0.07-0.39)0.69 (0.41-0.97)RLJ0.25 (0.09-0.41)0.46 (0.12-0.80)Legend.n: number of the wrists,RLJ: volar recess of the radio-lunate joint. Values in brackets are the 95% confidence intervals of the Cohen’s kappa.Figure 1provides a pictorial evidence of the appearance of CPP crystal deposits in the SLL.A: CPP crystal deposits (curved arrow) at the TFCC. The SLL is not assessable due to superimposition of other bones.B: in the same patient of figure 1A, CT scan shows the presence of a calcification of the dorsal aspect of the SLL (arrow).C: dorsal longitudinal scan of the SLL: isolated hyperechoic spot (arrowheads) inside the ligament.D: dorsal longitudinal scan of the SLL showing the presence of a large aggregate extending towards the extensor tendons and hyperechoic spots (arrowheads) within it.Legend.iii: third extensor compartment,iv: fourth extensor compartment,l: lunate bone,s:scaphoid bone.Conclusion:This study supports the diagnostic accuracy of US in evaluating wrist involvement in CPPD patients. SLL calcifications are a specific US finding of CPPD at wrist level.References:[1]Ziegeler K, Diekhoff T, Hermann S, et al. Low-dose computed tomography as diagnostic tool in calcium pyrophosphate deposition disease arthropathy: focus on ligamentous calcifications of the wrist. Clin Exp Rheumatol 2019;37:826-33.Disclosure of Interests:Edoardo Cipolletta: None declared, Gianluca Smerilli: None declared, Riccardo Mashadi Mirza: None declared, Andrea Di Matteo Grant/research support from: the publication was conducted while Dr. Di Matteo was an ARTICULUM fellow, Fausto Salaffi Speakers bureau: Dr. Salaffi reports personal fees from Bristol Myers Squibb, personal fees from Pfizer, personal fees from Novartis, personal fees from AbbVie, personal fees from Roche, personal fees from Merck Sharp & Dohme Italia, outside the submitted work., Walter Grassi Speakers bureau: Prof. Grassi reports personal fees from AbbVie, personal fees from Celgene, personal fees from Grünenthal, personal fees from Pfizer, personal fees from Union Chimique Belge Pharma, outside the submitted work., Emilio Filippucci Speakers bureau: Dr. Filippucci reports personal fees from AbbVie, personal fees from Bristol-Myers Squibb, personal fees from Celgene, personal fees from Roche, personal fees from Union Chimique Belge Pharma, personal fees from Pfizer, outside the submitted work.

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