1
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Qian W, Li Z. Expression and diagnostic significance of integrin beta-2 in synovial fluid of patients with osteoarthritis. J Orthop Surg (Hong Kong) 2023; 31:10225536221147213. [PMID: 37379363 DOI: 10.1177/10225536221147213] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/30/2023] Open
Abstract
OBJECTIVE Osteoarthritis (OA) is characterized by synovial cartilage degeneration and is the leading cause of disability and pain worldwide. This study sought to investigate the expression of integrin beta-2 (ITGB2) in synovial fluid of OA patients and its clinical significance. METHODS A total of 110 OA patients were enrolled, who were classified into grade I (N = 35), II (N = 42), and III (N = 33) according to the Kellgren-Lawrence classification, with 110 healthy subjects as controls, and their clinical data were compared. ITGB2 level was detected by RT-qPCR. The receiver operating characteristic curve was used to analyze the predictive value of ITGB2 on OA occurrence. The correlation between ITGB2 and bone metabolism indexes procollagen type I N-terminal peptide (PINP), bone glaprotein (BGP), bone alkaline phosphatase (BALP), and β-collagen I telopeptide (β-CTX) was analyzed by the Pearson method. Logistic regression model was performed to analyze the influencing factors of OA. RESULTS The content of red blood cells, white blood cells, PINP, BGP, and BALP was lowered in OA patients, while β-CTX was elevated. ITGB2 was highly-expressed in OA patients, negatively-correlated with PINP, BGP, and BALP, but positively-correlated with β-CTX. ITGB2 level increased with the elevation of OA grade. The ITGB2 level >1.375 had certain diagnostic values for OA. ITGB2 level is related to OA severity and may be a biomarker for OA classification. ITGB2 was an independent risk factor for OA. CONCLUSION High expression of ITGB2 in synovial fluid can assist OA diagnosis and may be a biomarker for OA grade.
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Affiliation(s)
- Weiwei Qian
- Hangzhou Fuyang District Bone Injury Hospital of Traditional Chinese Medicine, Hangzhou, China
| | - Zhen Li
- Hangzhou Fuyang District Bone Injury Hospital of Traditional Chinese Medicine, Hangzhou, China
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2
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Filippou G, Sirotti S. How can ultrasonography help in the management of CPPD? From diagnosis to clinical subset identification. Curr Opin Rheumatol 2023; 35:185-193. [PMID: 36943699 DOI: 10.1097/bor.0000000000000939] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2023]
Abstract
PURPOSE OF REVIEW Clinical manifestations of calcium pyrophosphate deposition (CPPD) disease are quite heterogeneous, ranging from asymptomatic presentation to severe forms of arthritis. In recent years, imaging, particularly ultrasound (US) has gained a central role for the diagnosis of CPPD. However, many questions are still open. Aim of this review is to present how US could be a key tool in the diagnosis and assessment of CPPD and for the identification of subsets of the disease. RECENT FINDINGS awareness and research interest around CPPD is increasing in the recent years, as several international taskforces are working on the validation of outcome measures and classification criteria for CPPD, but many pieces of the puzzle are still missing. Recent studies demonstrated that CPPD is an underdiagnosed disease, frequently misdiagnosed as rheumatoid arthritis or polymyalgia rheumatica. US has been increasingly used in the past decade for the diagnosis of CPPD and US definitions have been validated by the OMERACT US working group in the recent years, making of US a valuable tool for diagnosis. SUMMARY The most challenging aspects of CPPD are the differential diagnosis with other form of arthritis of the elderly, and the classification of patients in clinical subsets. In this review, we will present the available data for the use of US in the diagnosis of CPPD and we will provide a mainly experienced-based approach to the potential role of the technique in differential diagnosis and phenotypization of patients.
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Affiliation(s)
- Georgios Filippou
- IRCCS Ospedale Galeazzi - Sant'Ambrogio, Rheumatology Department, Milan, Italy
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3
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Cowley S, McCarthy G. Diagnosis and Treatment of Calcium Pyrophosphate Deposition (CPPD) Disease: A Review. Open Access Rheumatol 2023; 15:33-41. [PMID: 36987530 PMCID: PMC10040153 DOI: 10.2147/oarrr.s389664] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 03/16/2023] [Indexed: 03/30/2023] Open
Abstract
Calcium Pyrophosphate Dihydrate (CPPD) crystal-related arthropathies are a common cause of acute and chronic arthritis caused by the deposition of calcium pyrophosphate crystals in joints and soft tissues, resulting in inflammation and joint damage. They present with a wide spectrum of clinical manifestations and often present challenges to diagnosis and management as they commonly affect older co-morbid patients. The challenges are compounded by a lack of a well-defined description of CPPD. However, an international expert-driven process is underway to develop CPPD classification criteria. Treatment is also problematic as unlike gout, there are no agents available that decrease the crystal burden. Treatment options have often been extrapolated from gout treatment pathways without having extensive trials or a solid evidence base. It is hoped the new CPPD classification guidelines will contribute to large multicentre studies, with well-defined patient cohorts, which will facilitate the production of high-quality evidence to guide the management of this condition. Here, we discuss the barriers and facilitators in diagnosing and treating CPPD-related arthropathy.
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Affiliation(s)
- Sharon Cowley
- Department of Rheumatology, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Geraldine McCarthy
- Department of Rheumatology, Mater Misericordiae University Hospital, Dublin, Ireland
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4
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Imaging of Crystal Disorders:: Calcium Pyrophosphate Dihydrate Crystal Deposition Disease, Calcium Hydroxyapatite Crystal Deposition Disease and Gout Pathophysiology, Imaging, and Diagnosis. Radiol Clin North Am 2022; 60:641-656. [PMID: 35672096 DOI: 10.1016/j.rcl.2022.03.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Crystal arthropathies are a group of joint disorders due to deposition of crystals in and around joints that lead to joint destruction and soft tissue masses. Clinical presentation is variable and diagnosis might be challenging. In this article the pathophysiology is addressed, the preferred deposition of crystal arthropathies and imaging findings. Case studies of calcium pyrophosphate dihydrate crystal deposition disease, hydroxyapatite crystal deposition disease, and gout are shown. Guidelines for the use of dual-energy computed tomography are given to enable the diagnosis and follow-up of gout.
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5
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Shams S, Khan B, Jeffries A. Crowned dens syndrome—case of crystal deposition in cervical spine. Oxf Med Case Reports 2022; 2022:omab135. [PMID: 35083050 PMCID: PMC8787625 DOI: 10.1093/omcr/omab135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 10/17/2021] [Accepted: 11/18/2021] [Indexed: 11/12/2022] Open
Abstract
Neck pain can be very bothersome for patients, and most will seek analgesic relief as soon as possible. We present a case of crystal deposition in the cervical spine where a frail patient admitted for pneumonia developed severe neck pain raising suspicion of discitis, and did not respond to standard analgesic medications. Investigations revealed crystal deposition around the dens and alar ligaments (C1 and C2 Spine) suggestive of crowned dens syndrome, which responded promptly to steroid therapy and averting the patient from invasive investigations and intense treatment with antibiotics.
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Affiliation(s)
- Sabeeh Shams
- Rheumatology Department, Blackpool Teaching Hospital Foundation Trust, Blackpool FY3 8NR, UK
| | - Behram Khan
- Rheumatology Department, Blackpool Teaching Hospital Foundation Trust, Blackpool FY3 8NR, UK
| | - Andrew Jeffries
- Rheumatology Department, Blackpool Teaching Hospital Foundation Trust, Blackpool FY3 8NR, UK
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6
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Chotard E, Blanchard A, Ostertag A, Latourte A, Gailly G, Frochot V, Lioté F, Bousson V, Richette P, Bardin T, Vargas-Poussou R, Ea HK. Calcium Pyrophosphate Crystal Deposition in a Cohort of 57 Patients with Gitelman Syndrome. Rheumatology (Oxford) 2021; 61:2494-2503. [PMID: 34508565 DOI: 10.1093/rheumatology/keab578] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 07/06/2021] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE Gitelman syndrome (GS) is the most frequent salt-wasting genetic tubulopathy and a source of hypokalaemia and hypomagnesemia. Chondrocalcinosis (CC) is a frequent feature of GS. The aim of our study was to determine the prevalence, distribution patterns, clinical phenotypes and risk factors of CC in GS. METHODS This prospective study of a cohort of 57 patients with GS included a systematic screening for CC by peripheral joint radiography, cervical spine computerized tomography (CT) and joint ultrasonography. The prevalence of cervical C1-C2 CC by CT was compared between 33 GS patients and sex- and age-matched controls. Clinical and biochemical features were analysed to identify factors associated with CC. RESULTS Mean age of patients was 46.5 ± 12.4 years, 66.7% were women, and 93.0% carried SLC12A3 mutations. Mean serum magnesium level was 0.60 ± 0.30 mmol/l. CC was observed in 79% of patients, with the highest prevalence at the cervical spine (81.8%) followed by the knee (52.6%), wrist (50.9%), ankle (38.6%), temporomandibular joint (36.4%), shoulder (33.3%), hip (22.8%), elbow (14.0%) and sclero-choroid (12.1%). Prevalence of CC at the C1-C2 level was higher in the GS cohort than control group (72.7% vs 9.1%) (adjusted odds ratio 21.0, 95% CI 2.8-156.1, p= 0.003). Independent factors associated with CC were low serum magnesium level and age. CONCLUSION GS was associated with widespread CC, favoured by aging and hypomagnesemia. The C1-C2 level was the most affected site. Follow-up of this unique cohort will help understanding the clinical consequences of CC, especially the precise characterization of pyrophosphate arthropathy.
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Affiliation(s)
- Emile Chotard
- Université de Paris, INSERM UMR 1132, BIOSCAR, Hôpital Lariboisière, Service de rhumatologie, centre Viggo Petersen, DMU locomotion, APHP, Paris, France
| | - Anne Blanchard
- AP-HP, Hôpital européen Georges Pompidou, service de néphrologie, Paris, France
| | - Agnès Ostertag
- Université de Paris, INSERM UMR 1132, BIOSCAR, Hôpital Lariboisière, Service de rhumatologie, centre Viggo Petersen, DMU locomotion, APHP, Paris, France
| | - Augustin Latourte
- Université de Paris, INSERM UMR 1132, BIOSCAR, Hôpital Lariboisière, Service de rhumatologie, centre Viggo Petersen, DMU locomotion, APHP, Paris, France
| | - Gilles Gailly
- Université de Paris, INSERM UMR 1132, BIOSCAR, Hôpital Lariboisière, Service de rhumatologie, centre Viggo Petersen, DMU locomotion, APHP, Paris, France
| | - Vincent Frochot
- Hôpital Tenon, Service des explorations fonctionnelles multidisciplinaires, Sorbonne université, UMR_S1155, Paris, France
| | - Frédéric Lioté
- Université de Paris, INSERM UMR 1132, BIOSCAR, Hôpital Lariboisière, Service de rhumatologie, centre Viggo Petersen, DMU locomotion, APHP, Paris, France
| | - Valérie Bousson
- Université de Paris, hôpital Lariboisière, Service de radiologie, Paris, France
| | - Pascal Richette
- Université de Paris, INSERM UMR 1132, BIOSCAR, Hôpital Lariboisière, Service de rhumatologie, centre Viggo Petersen, DMU locomotion, APHP, Paris, France
| | - Thomas Bardin
- Université de Paris, INSERM UMR 1132, BIOSCAR, Hôpital Lariboisière, Service de rhumatologie, centre Viggo Petersen, DMU locomotion, APHP, Paris, France
| | - Rosa Vargas-Poussou
- AP-HP, Hôpital européen Georges Pompidou, service de génétique, Paris, France
| | - Hang Korng Ea
- Université de Paris, INSERM UMR 1132, BIOSCAR, Hôpital Lariboisière, Service de rhumatologie, centre Viggo Petersen, DMU locomotion, APHP, Paris, France
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7
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Gumucio R, Azuaga AB, Isern-Kebschull J, Ramirez J, Frade-Sosa B, Guañabens N. A Case Report of Exuberant Chondrocalcinosis of the Ankle: An Unusual Presentation. J Clin Rheumatol 2021; 27:e30-e31. [PMID: 33347036 DOI: 10.1097/rhu.0000000000001224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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8
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A critical review of the available evidence on the diagnosis and clinical features of CPPD: do we really need imaging? Clin Rheumatol 2020; 40:2581-2592. [PMID: 33231775 DOI: 10.1007/s10067-020-05516-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 11/14/2020] [Accepted: 11/16/2020] [Indexed: 02/08/2023]
Abstract
Imaging has been playing an important role in the pathogenetic and clinical characterisation of many rheumatic diseases, especially in the most recent years with the advent of many new, highly technological and promising techniques. Calcium pyrophosphate deposition disease (CPPD) benefited also from these new techniques, most of which can readily identify calcium crystals. Nowadays, imaging is used mainly to identify crystals in joints but given the complexity of CPPD, imaging should be used with an "holistic" approach in order to gain insights in the pathogenesis, spectrum of clinical manifestations and natural history of the disease. Furthermore, overlap or association of CPPD with other prevalent diseases of the elderly makes the differential diagnosis challenging. In this review, we provide a critical review of the current knowledge on the use of imaging both for the identification of crystals and for its application in clinical practice as an aid for determining the impact of the disease on patients.Key Points• CPPD is a complex disease with a wide spectrum of clinical manifestations and understanding of pathogenetic mechanisms and clinical phenotypes is essential for correct characterisation• Imaging has made important advances regarding identification of CPPD in recent years, and new, more sophisticated techniques are under investigation• Imaging has the potential to improve our knowledge on pathogenesis and clinical phenotypes of CPPD• Imaging techniques have to be tested thoroughly for reliability, discrimination and sensitivity to change before they can be implemented in clinical trials.
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9
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Filippou G, Scanu A, Adinolfi A, Toscano C, Gambera D, Largo R, Naredo E, Calvo E, Herrero-Beaumont G, Zufferey P, Bonjour CM, MacCarter DK, Makman S, Weber Z, Figus F, Möller I, Gutierrez M, Pineda C, Clavijo Cornejo D, Garcia H, Ilizaliturri V, Mendoza Torres J, Pichardo R, Rodriguez Delgado LC, Filippucci E, Cipolletta E, Serban T, Cirstoiu C, Vreju FA, Grecu D, Mouterde G, Govoni M, Punzi L, Damjanov NS, Keen HI, Bruyn GA, Terslev L, D'Agostino MA, Scirè CA, Iagnocco A. Criterion validity of ultrasound in the identification of calcium pyrophosphate crystal deposits at the knee: an OMERACT ultrasound study. Ann Rheum Dis 2020; 80:261-267. [PMID: 32988839 DOI: 10.1136/annrheumdis-2020-217998] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 08/03/2020] [Accepted: 08/21/2020] [Indexed: 12/29/2022]
Abstract
OBJECTIVE To evaluate the discriminatory ability of ultrasound in calcium pyrophosphate deposition disease (CPPD), using microscopic analysis of menisci and knee hyaline cartilage (HC) as reference standard. METHODS Consecutive patients scheduled for knee replacement surgery, due to osteoarthritis (OA), were enrolled. Each patient underwent ultrasound examination of the menisci and HC of the knee, scoring each site for presence/absence of CPPD. Ultrasound signs of inflammation (effusion, synovial proliferation and power Doppler) were assessed semiquantitatively (0-3). The menisci and condyles, retrieved during surgery, were examined microscopically by optical light microscopy and by compensated polarised microscopy. CPPs were scored as present/absent in six different samples from the surface and from the internal part of menisci and cartilage. Ultrasound and microscopic analysis were performed by different operators, blinded to each other's findings. RESULTS 11 researchers from seven countries participated in the study. Of 101 enrolled patients, 68 were included in the analysis. In 38 patients, the surgical specimens were insufficient. The overall diagnostic accuracy of ultrasound for CPPD was of 75%-sensitivity of 91% (range 71%-87% in single sites) and specificity of 59% (range 68%-92%). The best sensitivity and specificity were obtained by assessing in combination by ultrasound the medial meniscus and the medial condyle HC (88% and 76%, respectively). No differences were found between patients with and without CPPD regarding ultrasound signs of inflammation. CONCLUSION Ultrasound demonstrated to be an accurate tool for discriminating CPPD. No differences were found between patents with OA alone and CPPD plus OA regarding inflammation.
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Affiliation(s)
- Georgios Filippou
- Section of Rheumatology, Department of Medical Sciences, University of Ferrara, Ferrara, Italy .,Rheumatology Department, Luigi Sacco University Hospital, Milano, Italy
| | - Anna Scanu
- Department of Medicine-DIMED, Rheumatology Unit, University of Padova, Padova, Italy
| | - Antonella Adinolfi
- Rheumatology Department, ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy
| | - Carmela Toscano
- Rheumatology Department, Azienda Ospedaliera Regionale San Carlo, Potenza, Italy
| | - Dario Gambera
- Orthopedics Department, Rugani Hospital, Monteriggioni, Italy
| | - Raquel Largo
- Joint and Bone Research Unit, Rheumatology Department, IIS-Fundacion Jimenez Diaz, Madrid, Spain
| | - Esperanza Naredo
- Department of Rheumatology and Joint and Bone Research Unit, Hospital Universitario Fundacion Jimenez Diaz, Madrid, Spain
| | - Emilio Calvo
- Department of Orthopaedic Surgery, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - Gabriel Herrero-Beaumont
- Department of Rheumatology and Joint and Bone Research Unit, Hospital Universitario Fundacion Jimenez Diaz, Madrid, Spain
| | - Pascal Zufferey
- Rheumatology Department, University of Lausanne, CHUV, Lausanne, Switzerland
| | | | - Daryl K MacCarter
- Rheumatology Department, North Valley Hospital, Whitefish, Montana, USA
| | - Stanley Makman
- Rheumatology Department, North Valley Hospital, Whitefish, Montana, USA
| | - Zachary Weber
- Rheumatology Department, North Valley Hospital, Whitefish, Montana, USA
| | - Fabiana Figus
- Rheumatology Unit, Department of Clinical and Biological Sciences, Università degli Studi di Torino, Torino, Italy
| | - Ingrid Möller
- Rheumatology, Instituto Poal de Reumatologia, Barcelona, Spain
| | - Marwin Gutierrez
- Rheumatology Department, Instituto Nacional de Rehabilitacion, Mexico, Mexico
| | - Carlos Pineda
- Rheumatology Department, Instituto Nacional de Rehabilitacion, Mexico, Mexico
| | | | - Hector Garcia
- Rheumatology Department, Instituto Nacional de Rehabilitacion, Mexico, Mexico
| | - Victor Ilizaliturri
- Rheumatology Department, Instituto Nacional de Rehabilitacion, Mexico, Mexico
| | | | - Raul Pichardo
- Rheumatology Department, Instituto Nacional de Rehabilitacion, Mexico, Mexico
| | | | - Emilio Filippucci
- Rheumatology Unit, Department of Clinical and Molecular Sciences, Università Politecnica delle Marche, Ancona, Italy
| | - Edoardo Cipolletta
- Rheumatology Unit, Department of Clinical and Molecular Sciences, Università Politecnica delle Marche, Ancona, Italy
| | - Teodora Serban
- Rheumatology Department, Carol Davila University, Bucharest, Romania
| | - Catalin Cirstoiu
- Rheumatology Department, Carol Davila University, Bucharest, Romania
| | - Florentin Ananu Vreju
- Rheumatology Department, University of Medicine and Pharmacy of Craiova, Craiova, Romania
| | - Dan Grecu
- Rheumatology Department, University of Medicine and Pharmacy of Craiova, Craiova, Romania
| | - Gaël Mouterde
- Rheumatology, University of Montpellier, Montpellier, France
| | - Marcello Govoni
- Section of Rheumatology, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Leonardo Punzi
- Department of Medicine, Ospedale SS Giovanni e Paolo Venezia, Venezia, Italy
| | - Nemanja S Damjanov
- Rheumatology, University of Belgrade School of Medicine, Belgrade, Serbia.,Institute of Rheumatology, University of Belgrade, Belgrade, Serbia
| | - Helen Isobel Keen
- Medicine and Pharmacology Department, The University of Western Australia, Murdoch, Perth, Australia
| | - George Aw Bruyn
- Department of Rheumatology, Reumakliniek Lelystad, Lelystad, The Netherlands
| | - Lene Terslev
- Center for Rheumatology and Spine Diseases, Rigshospitalet, Copenhagen University, Copenhagen, Denmark
| | - Maria-Antonietta D'Agostino
- Infection et inflammation, Laboratory of Excellence INFLAMEX, Université Paris-Saclay, Montigny-Le-Bretonneux, France.,Rheumatology, Ambroise Paré Hospital, Boulogne-Billancourt, France
| | - Carlo Alberto Scirè
- Section of Rheumatology, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Annamaria Iagnocco
- Rheumatology Unit, Department of Clinical and Biological Sciences, Università degli Studi di Torino, Torino, Italy
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10
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There is no difference in postoperative pain, function and complications in patients with chondrocalcinosis in the outcome of total knee arthroplasty for end-stage osteoarthritis. Knee Surg Sports Traumatol Arthrosc 2020; 28:2970-2979. [PMID: 31552473 DOI: 10.1007/s00167-019-05725-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2019] [Accepted: 09/16/2019] [Indexed: 12/30/2022]
Abstract
PURPOSE Chondrocalcinosis is the radiographic appearance of calcium crystals in cartilage and other soft tissue. It is suggested that preoperative chondrocalcinosis predicts a worse outcome after total knee arthroplasty and it is unclear if chondrocalcinosis leads to more postoperative complications. This study aimed to compare function, pain, postoperative complications, postoperative signs of acute arthritis and revision rates between patients with and without chondrocalcinosis undergoing total knee arthroplasty for osteoarthritis. METHODS In this retrospective cohort study performed in 2017, 408 knees in 392 patients (16 bilateral total knee arthroplasties) were included. None of the patients received additional synovectomy. PROMs were evaluated after 1 year (n = 294) and 5 years (n = 308). The follow-up for clinical data was 5 years (n = 408). The range of final follow-up was 57-84 months. All preoperative radiographs were scored for chondrocalcinosis and Oxford Knee Score, Knee Society Score and Algofunctional Index were used to assess outcome. All clinical records were screened for postoperative complications (excessive wound discharge, infection, loosening, PAO, stiffness), arthritis after surgery and reoperation or revision for any reason. RESULTS Sixty-three knees (15.4%) showed signs of chondrocalcinosis. Male gender, higher age and lower BMI were risk factors for chondrocalcinosis. No difference was found in Oxford Knee Score, Knee Society Score and Algofunctional Index, nor in postoperative complications, postoperative signs of acute arthritis and revision rate. CONCLUSION Patients with and without chondrocalcinosis have the same outcome after total knee arthroplasty related to pain, functionality, complications, arthritis and revision after surgery for end-stage osteoarthritis. Chondrocalcinosis is not a contraindication for total knee arthroplasty and additional synovectomy is unnecessary. LEVEL OF EVIDENCE III.
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11
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Leverenz DL, Criscione-Schreiber LG. A Fuzzy Cause of Hip Pain. Am J Med 2020; 133:580-581. [PMID: 31715162 DOI: 10.1016/j.amjmed.2019.10.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Accepted: 10/04/2019] [Indexed: 11/30/2022]
Affiliation(s)
- David L Leverenz
- Department of Internal Medicine, Division of Rheumatology and Immunology, Duke University School of Medicine, Durham, N.C.
| | - Lisa G Criscione-Schreiber
- Department of Internal Medicine, Division of Rheumatology and Immunology, Duke University School of Medicine, Durham, N.C
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12
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Turaga S, Thomas M, Savy L, Schreiber BE. Pseudogout or pseudolymphoma? Calcium pyrophosphate deposition disease of the cervical spine: a rare presentation and literature review. BMJ Case Rep 2019; 12:12/12/e231508. [PMID: 31796457 DOI: 10.1136/bcr-2019-231508] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Calcium pyrophosphate deposition (CPPD) disease is a crystal arthropathy primarily affecting peripheral joints, most commonly the wrist and the knees. However, CPPD in the cervical spine is a rare entity. This report describes a case of CPPD of the cervical spine which presents with symptoms of neck pain and brachalgia. A 62-year-old woman presented with left-sided upper limb and neck pain. MRI scanning revealed a low signal abnormality within the C6 and C7 vertebrae, and the possibility of lymphoma was raised. The patient was recalled for gadolinium-enhanced scans which showed perivertebral and marrow enhancement. Fine-needle aspirate histology initially suggested a spindle cell tumour or lymphoma. However, CT-guided biopsy showed positively birefringent crystals, confirming CPPD. CPPD of the spine is a rare differential of nerve impingement in the cervical spine when MRI scanning perivertebral signal enhancement. Furthermore, CPPD of the spine can mimic malignancy.
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Affiliation(s)
- Sanchit Turaga
- Nuffield Department of Medicine, John Radcliffe Hospital, Oxford, UK
| | - Michael Thomas
- Department of Emergency Medicine, Royal Berkshire Hospital, Reading, UK
| | - Lloyd Savy
- Department of Neuroradiology, Royal Free London NHS Foundation Trust, London, UK
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13
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Winds of change in imaging of calcium crystal deposition diseases. Joint Bone Spine 2019; 86:665-668. [DOI: 10.1016/j.jbspin.2019.04.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Accepted: 04/17/2019] [Indexed: 12/26/2022]
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14
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Acute febrile torticollis. Eur Ann Otorhinolaryngol Head Neck Dis 2019; 136:515-516. [PMID: 31582331 DOI: 10.1016/j.anorl.2019.09.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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15
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Sousa APD, Moura C, da Hora PR, Santiago M. Calcium crystal-associated arthropathy mimicking a febrile systemic inflammatory disease in an elderly patient. Oxf Med Case Reports 2019; 2019:omz030. [PMID: 31198566 PMCID: PMC6544428 DOI: 10.1093/omcr/omz030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 02/07/2019] [Accepted: 02/24/2019] [Indexed: 12/27/2022] Open
Abstract
Crystal formation and deposition in the joints is an important and common cause of acute arthritis. The disease may present with fever and systemic signs. In this report, we describe the case of a 70-year-old man, who presented with a sudden and incapacitating polyarthritis of large and small joints, fever, asthenia and leukocytosis. After extensive investigation, radiography of the joints showed the presence of chondrocalcinosis. A few days after the beginning of the treatment with colchicine, he became completely asymptomatic, drawing one’s attention of calcium crystal-associated arthropathy as a cause of febrile systemic inflammatory disease particularly in elderly population.
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Affiliation(s)
- Anna Paula Duque Sousa
- Service of Rheumatology of Santa Izabel Hospital, Praça Almeida Couto 500, Salvador, BA, Brazil
| | - Carlos Moura
- Service of Rheumatology of Santa Izabel Hospital, Praça Almeida Couto 500, Salvador, BA, Brazil
| | | | - Mittermayer Santiago
- Service of Rheumatology of Santa Izabel Hospital, Praça Almeida Couto 500, Salvador, BA, Brazil.,Department of Internal Medicine, Bahiana School of Medicine and Public Health, Avenida Dom João VI 275, Brotas, Salvador, BA, Brazil.,Specialized Services in Rheumatology of Bahia, Rua Conde Filho 117, Graça, Salvador, BA, Brazil
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16
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Cooper R, Dudley J, Farmakiotis D. A Man With Headache, Fever, and Neck Stiffness. JAMA 2019; 321:1624-1625. [PMID: 30924841 DOI: 10.1001/jama.2019.1772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Rachel Cooper
- Lifespan/Rhode Island Hospital, Providence
- Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - John Dudley
- Lifespan/Rhode Island Hospital, Providence
- Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Dimitrios Farmakiotis
- Lifespan/Rhode Island Hospital, Providence
- Warren Alpert Medical School of Brown University, Providence, Rhode Island
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17
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Sansone V, Maiorano E, Galluzzo A, Pascale V. Calcific tendinopathy of the shoulder: clinical perspectives into the mechanisms, pathogenesis, and treatment. Orthop Res Rev 2018; 10:63-72. [PMID: 30774461 PMCID: PMC6209365 DOI: 10.2147/orr.s138225] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Calcific tendinopathy (CT) of the shoulder is a common, painful condition characterized by the presence of calcium deposits in the rotator cuff tendons. Current theories indicate that CT may be the result of a cell-mediated process in which, after a stage of calcium deposition, calcifications are spontaneously resorbed. However, in a minority of cases, this self-healing process is somehow disrupted, resulting in symptoms. Recent literature shows an emerging role of biological and genetic factors underlying CT. This new evidence could supplement the classic mechanical theory of rotator cuff tendinopathy complicated by calcium precipitation, and it may also explain why the majority of the therapies currently in use are only able to provide partially satisfactory outcomes. This review aims to summarize the current knowledge about the pathological processes underlying CT of the shoulder and thereby justify the quest for advanced biological treatments of this condition when it becomes symptomatic.
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Affiliation(s)
- Valerio Sansone
- Department of Orthopaedics, University of Milan, .,Department of Orthopaedics, I.R.C.C.S. Istituto Ortopedico Galeazzi, Milan, Italy,
| | | | | | - Valerio Pascale
- Department of Orthopaedics, University of Milan, .,Department of Orthopaedics, I.R.C.C.S. Istituto Ortopedico Galeazzi, Milan, Italy,
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Abstract
Gout is common in the elderly, affecting an estimated 4.7 million people aged > 60 years in the USA alone. The incidence and prevalence of gout increases, and male predisposition to gout reduces, with increasing age. The elderly have more comorbidities, and gout manifests differently, with more frequent involvement of knees, ankles, and wrists at disease onset, systemic upset, and tophi. Comorbidities and polypharmacy make the management of gout flares challenging in this population. Intra-articular corticosteroid injection remains the treatment of choice for accessible joints, oral prednisolone is preferred over low-dose colchicine, and non-steroidal anti-inflammatory drugs (NSAIDs) are best avoided. Xanthine oxidase inhibitors (XOI) remain the first-line treatment for hyperuricemia in the elderly. Arhalofenate, an emerging uricosuric anti-inflammatory drug, prevents gout flares while reducing serum urate. It may be particularly relevant in the treatment of gout in the elderly as they are unable to tolerate long-term colchicine for flare prophylaxis and frequently have contraindications to corticosteroids and NSAIDs. However, given its modest urate-lowering effect, it can only be used in combination with an XOI, and the safety and efficacy of this drug has not been examined in the elderly or in those with chronic kidney disease. Diuretics and beta-blockers should be discontinued where feasible, whereas low-dose aspirin can be continued if otherwise indicated.
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Affiliation(s)
- Abhishek Abhishek
- Division of Rheumatology, Orthopaedics, and Dermatology, School of Medicine, University of Nottingham, Nottingham, UK.
- Academic Rheumatology, Clinical Sciences Building, City Hospital Nottingham, Nottingham, NG5 1PB, UK.
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19
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Mobasheri A, Matta C, Uzielienè I, Budd E, Martín-Vasallo P, Bernotiene E. The chondrocyte channelome: A narrative review. Joint Bone Spine 2018; 86:29-35. [PMID: 29452304 DOI: 10.1016/j.jbspin.2018.01.012] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Accepted: 01/31/2018] [Indexed: 12/24/2022]
Abstract
Chondrocytes are the main cells in the extracellular matrix (ECM) of articular cartilage and possess a highly differentiated phenotype that is the hallmark of the unique physiological functions of this specialised load-bearing connective tissue. The plasma membrane of articular chondrocytes contains a rich and diverse complement of membrane proteins, known as the membranome, which defines the cell surface phenotype of the cells. The membranome is a key target of pharmacological agents and is important for chondrocyte function. It includes channels, transporters, enzymes, receptors, and anchors for intracellular, cytoskeletal and ECM proteins and other macromolecular complexes. The chondrocyte channelome is a sub-compartment of the membranome and includes a complete set of ion channels and porins expressed in these cells. Many of these are multi-functional proteins with "moonlighting" roles, serving as channels, receptors and signalling components of larger molecular assemblies. The aim of this review is to summarise our current knowledge of the fundamental aspects of the chondrocyte channelome, discuss its relevance to cartilage biology and highlight its possible role in the pathogenesis of osteoarthritis (OA). Excessive and inappropriate mechanical loads, an inflammatory micro-environment, alternative splicing of channel components or accumulation of basic calcium phosphate crystals can result in an altered chondrocyte channelome impairing its function. Alterations in Ca2+ signalling may lead to defective synthesis of ECM macromolecules and aggravated catabolic responses in chondrocytes, which is an important and relatively unexplored aspect of the complex and poorly understood mechanism of OA development.
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Affiliation(s)
- Ali Mobasheri
- Department of Veterinary Pre-Clinical Sciences, School of Veterinary Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey, United Kingdom; Arthritis Research UK Centre for Sport, Exercise and Osteoarthritis, Queen's Medical Centre, Nottingham, United Kingdom; Department of Regenerative Medicine, State Research Institute Centre for Innovative Medicine, Vilnius, Lithuania.
| | - Csaba Matta
- Department of Anatomy, Histology and Embryology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Ilona Uzielienè
- Department of Regenerative Medicine, State Research Institute Centre for Innovative Medicine, Vilnius, Lithuania
| | - Emma Budd
- Department of Veterinary Pre-Clinical Sciences, School of Veterinary Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey, United Kingdom
| | - Pablo Martín-Vasallo
- Department of Biochemistry and Molecular Biology, University of La Laguna, Tenerife, Spain
| | - Eiva Bernotiene
- Department of Regenerative Medicine, State Research Institute Centre for Innovative Medicine, Vilnius, Lithuania
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20
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Luu Q, Nasibi S, Sharma P, Bonura A, Massasso D. A case report of basic calcium phosphate deposition disease mimicking septic arthritis. Int J Rheum Dis 2017; 21:549-551. [PMID: 29205875 DOI: 10.1111/1756-185x.13232] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
We report a case of a 53-year-old man who presented with a diagnostic dilemma mimicking septic arthritis. It is important to consider the diagnosis of calcific peri-arthritis clinically and recognize the hallmarks on radiograph and magnetic resonance imaging as this disease process resolves completely with conservative management like in our patient, and does not require operative intervention.
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Affiliation(s)
- Queenie Luu
- Department of Rheumatology, Liverpool Hospital, Sydney, Australia
| | - Siroos Nasibi
- Department of Radiology, Liverpool Hospital, Sydney, Australia
| | - Praneal Sharma
- Department of Radiology, Liverpool Hospital, Sydney, Australia
| | - Andrew Bonura
- Department of Radiology, Liverpool Hospital, Sydney, Australia
| | - David Massasso
- Department of Rheumatology, Liverpool Hospital, Sydney, Australia
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21
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Klontzas ME, Vassalou EE, Zibis AH, Karantanas AH. Hydroxyapatite deposition disease around the hip: outcomes of CT-guided treatment. Diagn Interv Radiol 2017; 22:466-70. [PMID: 27537854 DOI: 10.5152/dir.2016.15616] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
PURPOSE Hydroxyapatite deposition disease (HADD) around the hip joint is a self-limiting condition usually treated conservatively. The aim of the present study is to directly compare the outcomes of CT-guided and conservative treatments in cases of refractory hip HADD. METHODS Two groups of patients with refractory hip HADD were prospectively constructed from a pool of 484 patients referred for greater trochanter pain syndrome, based on the presence of calcifications around the hip and the failure of conservative treatment. Study group included 22 hips, which underwent CT-guided barbotage and steroid injection treatment, whereas control group consisted of 28 hips that were treated conservatively. Evaluation of the outcome of both groups was performed over a one-year follow-up period with the use of a score measuring clinical improvement in terms of pain and functional impairment. RESULTS Three weeks after the initiation of treatment, study group exhibited significantly higher scores compared with the control group (P < 0.001). Improvement scores of the control group were similar to the study group after three months of treatment (P > 0.1). CONCLUSION CT-guided treatment provides relief of debilitating symptoms in the acute phase.
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Affiliation(s)
- Michail E Klontzas
- Department of Radiology, Medical School, University of Crete and the Department of Medical Imaging, University Hospital of Heraklion, Crete, Greece.
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Abstract
PURPOSE OF REVIEW Calcium pyrophosphate (CPP) crystal disease is a common rheumatologic disorder that has received limited attention from the scientific community. This review is aimed at summarizing current evidence for managing CPP disease (CPPD), focusing on recently reported advances. RECENT FINDINGS New data from case series indicate that interleukin-1β inhibitors can help patients with refractory forms of CPPD. Methotrexate, formerly a promising agent, failed to demonstrate benefits in a recent trial, but still merits consideration for some patients. No significant advances on crystal dissolution have been achieved to date. Proper characterization of the CPP crystal disease picture is needed, ruling out the possible coexistence of another persistent arthritis unrelated to the CPP deposition. SUMMARY Advances on CPP crystal dissolution and establishing definitions of the clinical spectrum of CPPD remain the main challenges for CPP crystal disease management.
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23
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Combining field effect scanning electron microscopy, deep UV fluorescence, Raman, classical and synchrotron radiation Fourier transform Infra-Red Spectroscopy in the study of crystal-containing kidney biopsies. CR CHIM 2016. [DOI: 10.1016/j.crci.2015.03.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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24
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Román Sastre MM, Vega González ML. Pyrophosphate arthropathy causing shoulder pain: Value of ultrasound in its therapeutic approach. REUMATOLOGIA CLINICA 2016; 12:351-353. [PMID: 26711842 DOI: 10.1016/j.reuma.2015.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Revised: 07/13/2015] [Accepted: 09/04/2015] [Indexed: 06/05/2023]
Affiliation(s)
- Mónica M Román Sastre
- Servicio de Radiodiagnóstico, Hospital Clínico Universitario San Carlos, Madrid, España.
| | - M Luisa Vega González
- Servicio de Radiodiagnóstico, Hospital Clínico Universitario San Carlos, Madrid, España
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Omoumi P, Zufferey P, Malghem J, So A. Imaging in Gout and Other Crystal-Related Arthropathies. Rheum Dis Clin North Am 2016; 42:621-644. [PMID: 27742018 DOI: 10.1016/j.rdc.2016.07.005] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
In this article, the authors consider the manifestations of intraarticular and periarticular crystal deposits. Most cases of crystal deposits are asymptomatic and represent incidental findings at imaging. In symptomatic arthropathies, imaging can play an important role in the diagnosis and assessment of disease progression and the extent of crystal deposits. Conventional radiography is the most common imaging modality. But ultrasound, conventional computerized tomography (CT), dual-energy CT, and MRI play an increasing role. The authors review typical radiographic features of crystal-induced arthropathies and findings that help to differentiate them. The authors also emphasize the increasing role of complementary imaging techniques.
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Affiliation(s)
- Patrick Omoumi
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital, Rue du Bugnon 46, Lausanne 1011, Switzerland.
| | - Pascal Zufferey
- Department of Rheumatology, Lausanne University Hospital, Av Pierre Decker 5, Lausanne 1011, Switzerland
| | - Jacques Malghem
- Department of Radiology, Saint Luc University Hospital, UC Louvain, Av Hippocrate 10, Brussels 1200, Belgium
| | - Alexander So
- Department of Rheumatology, Lausanne University Hospital, Av Pierre Decker 5, Lausanne 1011, Switzerland
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Rheinboldt M, Scher C. Musculoskeletal ultrasonography in the diagnosis of acute crystalline synovitis. Emerg Radiol 2016; 23:623-632. [DOI: 10.1007/s10140-016-1419-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Accepted: 06/28/2016] [Indexed: 12/19/2022]
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Dual-Energy Computed Tomography Demonstrating Destructive Calcium Pyrophosphate Deposition Disease of the Distal Radioulnar Joint Mimicking Tophaceous Gout. J Clin Rheumatol 2016; 21:314-7. [PMID: 26267716 DOI: 10.1097/rhu.0000000000000292] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Calcium pyrophosphate dihydrate deposition (CPPD) disease is a common etiology of crystalline arthropathy; however, it can manifest in multiple patterns such as acute calcium pyrophosphate (CPP) crystal arthritis, osteoarthritis with CPPD, and chronic CPP crystal inflammatory arthritis. Tumoral or tophaceous-like CPPD is a rare manifestation that is occasionally mistaken for gouty tophus or a soft tissue malignancy. Dual-energy computed tomography (DECT) is a new imaging modality currently utilized in assessing monosodium urate crystal deposition; however, its value in CPPD is uncertain. We describe a case using DECT to diagnose tumoral CPPD mimicking tophaceous gout versus recurrence of a previous synovial sarcoma. The imaging findings on DECT prevented unnecessary surgery to assess for possible malignancy, allowing for the prompt diagnosis of tumoral CPPD. Further studies should be performed to determine the role of DECT in assessing for crystalline deposition disease other than gout.
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Abstract
The calcification of knee ligaments is a finding noted only in a handful of case reports. The finding of an anterior cruciate ligament calcification has been reported once in the literature. Comparable studies involving the posterior cruciate ligament, medial collateral ligament and an ossicle within the anterior cruciate ligament are likewise discussed in reports of symptomatic patients. We report a case of incidentally discovered anterior cruciate ligament calcification. We discuss the likely etiology and clinical implications of this finding.
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Affiliation(s)
- Hisami Hayashi
- Department of Radiology, UCLA Harbor Medical Center, Torrance, USA
| | - Hans Fischer
- Department of Radiology, UCLA Harbor Medical Center, Torrance, USA
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30
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Gras P, Baker A, Combes C, Rey C, Sarda S, Wright AJ, Smith ME, Hanna JV, Gervais C, Laurencin D, Bonhomme C. From crystalline to amorphous calcium pyrophosphates: A solid state Nuclear Magnetic Resonance perspective. Acta Biomater 2016; 31:348-357. [PMID: 26476341 DOI: 10.1016/j.actbio.2015.10.016] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Revised: 09/09/2015] [Accepted: 10/12/2015] [Indexed: 12/14/2022]
Abstract
Hydrated calcium pyrophosphates (CPP, Ca2P2O7·nH2O) are a fundamental family of materials among osteoarticular pathologic calcifications. In this contribution, a comprehensive multinuclear NMR (Nuclear Magnetic Resonance) study of four crystalline and two amorphous phases of this family is presented. (1)H, (31)P and (43)Ca MAS (Magic Angle Spinning) NMR spectra were recorded, leading to informative fingerprints characterizing each compound. In particular, different (1)H and (43)Ca solid state NMR signatures were observed for the amorphous phases, depending on the synthetic procedure used. The NMR parameters of the crystalline phases were determined using the GIPAW (Gauge Including Projected Augmented Wave) DFT approach, based on first-principles calculations. In some cases, relaxed structures were found to improve the agreement between experimental and calculated values, demonstrating the importance of proton positions and pyrophosphate local geometry in this particular NMR crystallography approach. Such calculations serve as a basis for the future ab initio modeling of the amorphous CPP phases. STATEMENT OF SIGNIFICANCE The general concept of NMR crystallography is applied to the detailed study of calcium pyrophosphates (CPP), whether hydrated or not, and whether crystalline or amorphous. CPP are a fundamental family of materials among osteoarticular pathologic calcifications. Their prevalence increases with age, impacting on 17.5% of the population after the age of 80. They are frequently involved or associated with acute articular arthritis such as pseudogout. Current treatments are mainly directed at relieving the symptoms of joint inflammation but not at inhibiting CPP formation nor at dissolving these crystals. The combination of advanced NMR techniques, modeling and DFT based calculation of NMR parameters allows new original insights in the detailed structural description of this important class of biomaterials.
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Affiliation(s)
- Pierre Gras
- CIRIMAT, INPT-CNRS-UPS, Université de Toulouse, ENSIACET, Toulouse, France
| | - Annabelle Baker
- School of Chemistry, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK
| | - Christèle Combes
- CIRIMAT, INPT-CNRS-UPS, Université de Toulouse, ENSIACET, Toulouse, France
| | - Christian Rey
- CIRIMAT, INPT-CNRS-UPS, Université de Toulouse, ENSIACET, Toulouse, France
| | - Stéphanie Sarda
- CIRIMAT, INPT-CNRS-UPS, Université de Toulouse, Université Paul Sabatier, Toulouse, France
| | - Adrian J Wright
- School of Chemistry, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK
| | - Mark E Smith
- Vice-Chancellor's Office, University House, Lancaster University, Lancaster LA14YW, UK; Department of Physics, University of Warwick, Coventry CV4 7AL, UK
| | - John V Hanna
- Department of Physics, University of Warwick, Coventry CV4 7AL, UK
| | - Christel Gervais
- Sorbonne Universités, UPMC Univ Paris 06, CNRS, Collège de France, UMR 7574, Chimie de la Matière Condensée de Paris, 75005 Paris, France
| | - Danielle Laurencin
- Institut Charles Gerhardt de Montpellier, UMR 5253, CNRS-UM-ENSCM, Université de Montpellier, Montpellier, France
| | - Christian Bonhomme
- Sorbonne Universités, UPMC Univ Paris 06, CNRS, Collège de France, UMR 7574, Chimie de la Matière Condensée de Paris, 75005 Paris, France.
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Chung SW, Yoo JJ, Lee JW, Ha YJ, Kang EH, Song YW, Lee YJ. A Case of Acute Calcium Pyrophosphate Crystal Arthritis in the Lumbar Facet Joint. JOURNAL OF RHEUMATIC DISEASES 2016. [DOI: 10.4078/jrd.2016.23.2.125] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Sang Wan Chung
- Division of Rheumatology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Jong Jin Yoo
- Department of Internal Medicine, Kangdong Sacred Heart Hospital, Seoul, Korea
| | - Joon Woo Lee
- Department of Radiology, Seoul National University Bundang Hospital, Seongnam, Korea
| | - You-Jung Ha
- Division of Rheumatology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Eun Ha Kang
- Division of Rheumatology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Yeong Wook Song
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Yun Jong Lee
- Division of Rheumatology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
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