Abstract Radiographic features of hand and wrist involvement in 26 patients with hemochromatosis and in 26 patients with idiopathic calcium pyrophosphate dihydrate (CPPD) crystal deposition disease were compared. Deposition of calcium pyrophosphate dihydrate (CPPD) causes this form of arthritis. There was no past medical history of note. (3,4), Molecular genetics studies have identified two genetic locations for familial CC: one related to a mutation in the long arm of chromosome 8 (8q), and the other resulting from a mutation on the short arm of chromosome 5 (5p). 4, © 2020 Radiological Society of North America, https://doi.org/10.1148/radiology.147.2.6300958, Comment on: Hereditary hemochromatosis arthropathy and Doppler ultrasound findings of synovitis, Silicone Metacarpophalangeal Arthroplasty for Osteoarthritis: Long-Term Results, Imaging in Gout and Other Crystal-Related Arthropathies, Clinical-Pathological Conference Series from the Medical University of Graz, T2 black lesions on routine knee MRI: differential considerations, Arthropathy in haematological disorders in children, Plain Radiography and Advanced Imaging of Calcium Pyrophosphate Dihydrate Crystal Deposition Disease and of Arthropathy Associated With Basic Calcium Phosphate Crystal Deposition, Kapitel E1 Literaturverzeichnis zu Peter, Pichler, Müller-Ladner (Hrsg. 3, Rheumatic Disease Clinics of North America, Vol. Enhanced MR imaging of the shoulder, and sternoclavicular and acromioclavicular joint arthritis in primary hemochromatosis. 19, No. 4, JCR: Journal of Clinical Rheumatology, Vol. Ahn JK, Kim HJ, Kim EH, Jeon CH, Cha HS, Ha CW, et al. 26, No. Chapter 47. 57, No. Had the article been titled: "Calcium pyrophosphate deposition disease" I would probably not have found the info I was searching for. Efficacy of anakinra in calcium pyrophosphate crystal-induced arthritis: a report of 16 cases and review of the literature. The Archives of Rheumatology is indexed in the Science Citation Index Expanded - SCIE, Embase, Scopus and other databases. 14, No. Abhishek A, Doherty M. Pathophysiology of articular chondrocalcinosis--role of ANKH. (9) CPPD can also be associated with tendinitis, tenosynovitis and bursitis. Among older adults, CPPD is a common cause of sudden (acute) arthritis in … 5, No. 1, No. Zhang W, Doherty M, Pascual E, Barskova V, Guerne PA, Jansen TL, et al. It occurs when calcium pyrophosphate crystals sit in the joint and surrounding tissues and cause symptoms like gout. The author declared no conflicts of interest with respect to the authorship and/or publication of this article. Creative Commons Attribution-NonCommercial 4.0 International License. Over time joint deformity often occurs. 9, Current Problems in Diagnostic Radiology, Vol. Figure 4. Chondrocalcinosis of hip (Case 1). Ann Rheum Dis 2011;70:571-5. Elbow . Netter P, Bardin T, Bianchi A, Richette P, Loeuille D. The ANKH gene and familial calcium pyrophosphate dihydrate deposition disease. Chapter 333. 1, 30 November 2010 | Arthritis & Rheumatism, Vol. 4, The Journal of Hand Surgery, Vol. EULAR recommendations for calcium pyrophosphate deposition. 62, No. Radiology 1983; 147:377. 22, No. Curr Opin Rheumatol 2009;21:124-31. For a general discussion, and for links to other system specific manifestations, please refer to the article on hemochromatosis . An intra-articular injection of corticosteroid can be very effective in reducing symptoms in patients who have a single affected joint. Hydroxyapatite and calcium pyrophosphate crystal deposition are commonly associated with hemochromatosis and often happen concomitantly. Unlike in gout, there is currently no effective treatment that reduces or removes calcium pyrophosphate crystals from a joint. Part II: management. Adamson TC 3rd, Resnik CS, Guerra J Jr, et al. 16, No. Zhang W, Doherty M, Bardin T, Barskova V, Guerne PA, Jansen TL, et al. 2, EMC - Radiologie et imagerie médicale - Musculosquelettique - Neurologique - Maxillofaciale, Vol. Curr Rheumatol Rep 2004;6:221-7. (10) It is polyarticular in approximately two-thirds of patients, and often occurs in an asymmetric pattern. On examination there were bilateral, bony, metacarpophalangeal (MCP) joint swellings and painful restriction of movement in his right hip. On examination, there was swelling and painful restriction of movement in her right knee. Ther Adv Musculoskelet Dis 2012;4:121-31. We are attending a patient who had calcium pyrophosphate crystals in the 32, No. Hum Mol Genet 1995;4:1225-8. Knee joints with calcification of menisci (Case 1). This likely accounts for the acute flares. 43, No. 14, No. Furthermore, an oral nonsteroidal anti-inflammatory drug or low dose colchicine may be effective in reducing acute symptoms. Berlin Heidelberg; Springer-Verlag; 2010. p. 265-8. Yazılım Parkı - Online Journal Publishing and Management System. Part I: terminology and diagnosis. Calcium pyrophosphate deposition (CPPD) disease, commonly called “pseudogout,” is a painful form of arthritis that comes on suddenly. A 54 year old man gave a two year history of a painful right hip, fingers, and wrists. 12, No. Chondrocalcinosis becomes increasingly frequent with advancing age such that it can be found in 20% of the population aged in excess of 60 years. Radiographic and histologic features, Les manifestations articulaires révélatrices de l'hémochromatose génétique. In this article, we report two young patients who were investigated for recurrent joint pain due to CPPD disease. Internal Medicine. Radiology. McCarty DJ. Over time, joints may degenerate, or break down, resulting in chronic disability. These radiographic abnormalities are most common at the An Illustrated Radiological Guide. Richette P, Bardin T, Doherty M. An update on the epidemiology of calcium pyrophosphate dihydrate crystal deposition disease. 2, La Revue de Médecine Interne, Vol. CPP deposition disease is a loosely defined entity secondary to the deposition of calcium pyrophosphate dihydrate (CPPD) crystals in articular tissues. Australian Doctor 2009;21-9. Calcium pyrophosphate dihydrate (CPPD) crystal deposition disease is characterized by the deposition of CPPD crystals in the articular cartilage visualized as intra-articular calcifications [chondrocalcinosis (CC)], with identification of the crystals in the synovial fluid, … Second patient was a clear sporadic case of CC which is rare in the literature. During her stay at the hospital, she developed a right knee joint pain and an effusion. 9, No. Calcium pyrophosphate dihydrate (CPPD) arthritis is a joint disease that can cause attacks of arthritis. Figure 2. She gave a history of recurrent pain and swelling of her right knee joint and wrists for the past five years and was treated symptomatically by a general practitioner. Idiopathic calcium pyrophosphate dihydrate (CPPD) crystal deposition disease in a young male patient: a case report. Calcium pyrophosphate dihydrate (CPPD) crystal deposition disease is characterized by the deposition of CPPD crystals in the articular cartilage visualized as intra-articular calcifications [chondrocalcinosis (CC)], with identification of the crystals in the synovial fluid, and an acute arthropathy called pseudogout. Characteristic findings allow the radiologist to favor one diagnosis over the other. Dalbeth N, McQueen FM. 16, No. An award-winning, radiologic teaching site for medical students and those starting out in radiology focusing on chest, GI, cardiac and musculoskeletal diseases containing hundreds of lectures, quizzes, hand-out notes, interactive material, most commons lists and pictorial differential diagnoses Am J Med 1974;56:307-14. Specifically, calcium pyrophosphate dihydrate crystals were seen as characteristic linear hyperechoic bands positioned along the major axis of the tendon (arrows). CPPD deposition can be completely asymptomatic and is actually quite common in the elderly (50%) leading to the incidental finding of chondrocalcinosis by radiographic imaging. Two radiologists independently examined the radiographs without knowledge of the specific group to which the patient belonged. 4, 30 June 2016 | Wiener klinische Wochenschrift, Vol. Calcium pyrophosphate deposition disease (CPDD) is a type of arthritis caused by the deposition of calcium pyrophosphate crystals, and may present as either acute or chronic arthritis. (11,15), Aspiration of an affected joint not only provides fluid for confirmation of the diagnosis but also exclusion of infection and temporary relief from pain due to a reduction in the fluid volume within the joint. For a general discussion, and for links to other system specific manifestations, please refer to the article on hemochromatosis. (11,13) Linear or punctate calcification of the hyaline and fibrocartilage is the characteristic finding on plain X-ray in CC.(14). Development of CPPD crystal deposition disease in young people (<55 years) may be associated with metabolic diseases such as hemochromatosis, hyperparathyroidism, hypomagnesemia, Wilson’s disease, hypothyroidism, gout, acromegaly, and X-linked hypophosphatemic rickets. Joint Bone Spine 2013;80:178-82. These disorders comprise the spectrum of calcium pyrophosphate crystal deposition (CPPD) disease . Comment In this report, we aimed to highlight the sonographic pres-entations of calcium pyrophosphate dihydrate crystal depos - its in the Achilles tendon. Deposition of calcium pyrophosphate dihydrate (CPPD) causes this form of arthritis. 4, Seminars in Arthritis and Rheumatism, Vol. Some treatment options for the arthritis pain do exist, but these do not treat the underlying crystal deposition. Al-Tubaikh JA. Longo D, Fauci A, Kasper D. Gout and other crystal- associated arthropathies. Untreated calcium pyrophosphate deposition (CPPD) may lead to severe, painful attacks or chronic (long-term) pain and inflammation. The results of this study clearly establish that structural joint diseases in the two disorders are not identical. menisci) or hyaline cartilage. There was a family history of her father and younger sister having similar problems and her father (64 years old) was being followed-up at the clinic for CC. Harrison’s Principles of Internal Medicine. These radiographic differences indicate that the arthropathy of hemochromatosis is related to factors additional to the presence of CPPD crystals, specifically, the more prevalent narrowing of the metacarpophalangeal joint spaces, including those in the fourth and fifth digits, peculiar hook-like osteophytes on the radial aspect of the metacarpal heads, and less prevalent separation of the scaphoid and the lunate. 128, No. Figure 1. calcium pyrophosphate crystal deposition are uncorn- mon. 6, Annals of the Rheumatic Diseases, Vol. Our patients were managed with steroid injections and nonsteroidal anti-inflammatory drug for acute attacks and physiotherapy to reduce pain and keep the joints flexible. Knees show chondrocalcinosis involving the menisci and predominant patellofemoral joint osteoarthritis (Case 2). Joint Bone Spine 2004;71:365-8. van der Korst JK, Geerards J, Driessens FC. That was the term entered into the search engine when researching the diagnosis. 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