Imaging of Calcifying and Ossifying Disorders of the Spine

Neurographics ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. 49-58
Author(s):  
S.G. Alkhatib ◽  
K.A. Shah ◽  
K.J. Abrams

Substantial advances in the availability of spinal imaging have led to the increasing use of spinal imaging in the evaluation of patients with neck and back pain. This has resulted in the recognition of a diverse collection of spinal disorders, characterized by heterotopic calcification and ossification. Despite the increasing frequency at which these conditions are being diagnosed, there still exists a lack of awareness of the imaging characteristics of some of these calcifying and ossifying spinal disorders. Here, we review the imaging characteristics of ankylosing spondylitis, arachnoiditis ossificans, calcific discitis, calcific tendonitis of the longus colli, calcium pyrophosphate dihydrate deposition, crowned dens syndrome, diffuse idiopathic skeletal hyperostosis, ossification of the ligamentum flavum, and ossification of the posterior longitudinal ligament. Radiologists and clinicians alike should be familiar with these calcifying and ossifying spinal disorders to aid in an accurate diagnosis and to guide clinical management.Learning Objectives: Recognize the clinical features and imaging findings of various calcifying and ossifying disorders of the spine.

1989 ◽  
Vol 71 (1) ◽  
pp. 141-143 ◽  
Author(s):  
Samuel F. Ciricillo ◽  
Philip R. Weinstein

✓ The authors report a case of progressive foramen magnum syndrome due to deposits of calcium pyrophosphate dihydrate crystals, which caused reactive hypertrophy in the posterior longitudinal ligament at C-1 and in the transverse ligament of the atlas in an 84-year-old woman. This is the first reported case of symptomatic pseudogout in this anatomic location. Rapid neurological recovery followed transoral decompression of the cervicomedullary junction.


1984 ◽  
Vol 60 (1) ◽  
pp. 69-80 ◽  
Author(s):  
Chikao Nagashima ◽  
Motohide Takahama ◽  
Toshikatsu Shibata ◽  
Hiroaki Nakamura ◽  
Keiichi Okada ◽  
...  

✓ Three cases of cervical myeloradiculopathy associated with multiple calcified nodules containing identified calcium pyrophosphate dihydrate (CPPD) crystals in the ligamenta flava are described, with a comprehensive review of the 12 cases of this entity reported to date. The disease is characterized by: 1) oval or triangular areas of radiodensity in the posterior aspect of the cervical canal as seen in the lateral x-ray films and laminograms; 2) hemispherical areas of high density located almost symmetrically in the paramedial portion of the posterior spinal canal on computerized tomography scans; and 3) CPPD crystals in the nodules. It occurs independently or in association with cervical spondylosis or ossification of the posterior longitudinal ligament.


1998 ◽  
Vol 39 (3) ◽  
pp. 269-272
Author(s):  
H. Mizutani ◽  
S. Ohba ◽  
M. Mizutani ◽  
S. Sasaki ◽  
K. Ando ◽  
...  

2021 ◽  
Vol 9 (7) ◽  
pp. e002716
Author(s):  
Sang T. Kim ◽  
Jean Tayar ◽  
Siqing Fu ◽  
Danxia Ke ◽  
Elliot Norry ◽  
...  

With durable cancer responses, genetically modified cell therapies are being implemented in various cancers. However, these immune effector cell therapies can cause toxicities, including cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS). Pseudogout arthritis is an inflammatory arthritis induced by deposition of calcium pyrophosphate dihydrate crystals. Here, we report a case of pseudogout arthritis in a patient treated with MAGE-A4 directed T cell receptor T cells, for fallopian tube cancer. The patient developed CRS and ICANS 7 days after infusion of the T cells. Concurrently, the patient newly developed sudden onset of left knee arthritis. Synovial fluid analyses revealed the presence of calcium pyrophosphate dihydrate crystal. Notably, the pseudogout arthritis was resolved with tocilizumab, which was administered for the treatment of CRS and ICANS. Immunoprofiling of the synovial fluid showed that the proportion of inflammatory interleukin 17 (IL-17)-producing CD4+ T (Th17) cells and amount of IL-6 were notably increased, suggesting a potential role of Th17 cells in pseudogout arthritis after T-cell therapy. To the best of our knowledge, this is the first reported case of pseudogout arthritis after cell therapy. Clinicians, especially hematologists, oncologists and rheumatologists, should be aware that pseudogout arthritis can be associated with CRS/ICANS.


2020 ◽  
Vol 22 (1) ◽  
pp. 262
Author(s):  
Nobuyuki Onai ◽  
Chie Ogasawara

Calcium pyrophosphate dihydrate (CPPD) crystals are formed locally within the joints, leading to pseudogout. Although the mobilization of local granulocytes can be observed in joints where pseudogout has manifested, the mechanism of this activity remains poorly understood. In this study, CPPD crystals were administered to mice, and the dynamics of splenic and peripheral blood myeloid cells were analyzed. As a result, levels of both granulocytes and monocytes were found to increase following CPPD crystal administration in a concentration-dependent manner, with a concomitant decrease in lymphocytes in the peripheral blood. In contrast, the levels of other cells, such as dendritic cell subsets, T-cells, and B-cells, remained unchanged in the spleen, following CPPD crystal administration. Furthermore, an increase in granulocytes/monocyte progenitors (GMPs) and a decrease in megakaryocyte/erythrocyte progenitors (MEPs) were also observed in the bone marrow. In addition, CPPD administration induced production of IL-1β, which acts on hematopoietic stem cells and hematopoietic progenitors and promotes myeloid cell differentiation and expansion. These results suggest that CPPD crystals act as a “danger signal” to induce IL-1β production, resulting in changes in course of hematopoietic progenitor cell differentiation and in increased granulocyte/monocyte levels, and contributing to the development of gout.


2004 ◽  
Vol 71 (5) ◽  
pp. 365-368 ◽  
Author(s):  
Patrick Netter ◽  
Thomas Bardin ◽  
Arnaud Bianchi ◽  
Pascal Richette ◽  
Damien Loeuille

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