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Adinolfi A, Sirotti S, Sakellariou G, Cipolletta E, Filippucci E, Porta F, Zanetti A, Ughi N, Sarzi-Puttini P, Scirè CA, Keen H, Pineda C, Terslev L, D’Agostino MA, Filippou G. Which are the most frequently involved peripheral joints in calcium pyrophosphate crystal deposition at imaging? A systematic literature review and meta-analysis by the OMERACT ultrasound – CPPD subgroup. Front Med (Lausanne) 2023; 10:1131362. [PMID: 36968827 PMCID: PMC10034772 DOI: 10.3389/fmed.2023.1131362] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Accepted: 02/09/2023] [Indexed: 03/11/2023] Open
Abstract
ObjectivesTo identify the prevalence of calcium pyrophosphate crystal deposition (CPPD) using ultrasound and conventional radiology at peripheral joints in patients with suspected or definite CPPD.MethodsA systematic literature search was performed in PubMed and Embase using pre-defined search strategies from inception to April 2021 to identify studies that evaluated conventional radiology and ultrasound in detecting CPPD at peripheral joints, including definite or suspected CPPD [Research question 1 (RQ1) and Research Question 2 (RQ2), respectively]. For the meta-analysis, the first, second, and third sub-analysis included studies with the knee, and knee or wrist as the index joint for CPPD (without restrictions on the reference standard) and synovial fluid analysis or histology as a reference standard (without restrictions on the index joint), respectively.ResultsOne-thousand eight hundred and twenty-seven manuscripts were identified, of which 94 articles were finally included. Twenty-two and seventy-two papers were included in RQ1 and RQ2, respectively. The knee had the highest prevalence for RQ1 and RQ2 by both conventional radiology and ultrasound, followed by the wrist with the highest prevalence for RQ1. The hand had the lowest CPPD prevalence. The third sub-analysis showed a higher CPPD prevalence on ultrasound than conventional radiology at the knee (only data available).ConclusionAmong all peripheral joints, the knees and wrists could be regarded as the target joints for CPPD detection by imaging. Furthermore, ultrasound seems to detect a higher number of calcium pyrophosphate deposits than conventional radiology, even when using a more restrictive reference standard.
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Affiliation(s)
- Antonella Adinolfi
- Rheumatology Division, Multispecialist Medical Department, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
- *Correspondence: Antonella Adinolfi,
| | - Silvia Sirotti
- IRCCS Ospedale Galeazzi – Sant’Ambrogio, Rheumatology Department, Milan, Italy
| | - Garifallia Sakellariou
- Department of Internal Medicine and Therapeutics, Università di Pavia, Pavia, Italy
- Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy
| | - Edoardo Cipolletta
- Rheumatology Unit, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, Ancona, Italy
| | - Emilio Filippucci
- Rheumatology Unit, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, Ancona, Italy
| | - Francesco Porta
- Interdisciplinary Pain Medicine Unit, Rheumatology Section, Santa Maria Maddalena Hospital, Rovigo, Italy
| | | | - Nicola Ughi
- Rheumatology Division, Multispecialist Medical Department, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
- SIR Epidemiology, Research Unit, Milan, Italy
| | - Piercarlo Sarzi-Puttini
- IRCCS Ospedale Galeazzi – Sant’Ambrogio, Rheumatology Department, Milan, Italy
- Department of Biomedical and Clinical Sciences, Università degli studi di Milano, Milan, Italy
| | - Carlo Alberto Scirè
- SIR Epidemiology, Research Unit, Milan, Italy
- School of Medicine, University of Milano Bicocca, Milan, Italy
| | - Helen Keen
- Medicine and Pharmacology Department, The University of Western Australia, Murdoch, Perth, WA, Australia
| | - Carlos Pineda
- Rheumatology Department, Instituto Nacional de Rehabilitacion, Mexico, Mexico
| | - Lene Terslev
- Center for Rheumatology and Spine Diseases, Rigshospitalet, Copenhagen University, Copenhagen, Denmark
| | | | - Georgios Filippou
- IRCCS Ospedale Galeazzi – Sant’Ambrogio, Rheumatology Department, Milan, Italy
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Chiba D, Sasaki T, Ishibashi Y. Greater medial meniscus extrusion seen on ultrasonography indicates the risk of MRI-detected complete medial meniscus posterior root tear in a Japanese population with knee pain. Sci Rep 2022; 12:4756. [PMID: 35306511 PMCID: PMC8934359 DOI: 10.1038/s41598-022-08604-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Accepted: 02/24/2022] [Indexed: 11/30/2022] Open
Abstract
To elucidate the association between medial meniscus extrusion measured on ultrasonography (MMEUS) and the prevalence of medial meniscus posterior root tear detected on magnetic resonance imaging (MMPRTMRI). We recruited 127 patients (135 knees; 90 females; mean age: 64.4 ± 8.7 years old; mean BMI: 25.5 ± 3.4 kg/m2) in this cross-sectional study. All participants had medial knee pain without a knee trauma or surgery history. Knee osteoarthritis (KOA) severity was evaluated using Kellgren-Lawrence grade (KLG) scores. Patients with KLG scores 0–1 and ≥ 2 were classified in non-radiographic (non-ROA) and radiographic KOA (ROA) groups, respectively. MMEUS was measured with patients in the supine position. Based on fat-suppressed T2-weighted images, MMPRTMRI was defined as the presence of “Ghost meniscus sign” and “Cleft/truncation sign”, indicating an abnormal high signal intensity of a completely disrupted posterior root. MMEUS was compared between MMPRT+ and MMPRT– patients using a non-paired t-test. Receiver operating characteristic (ROC) curves were used to determine the optimal cut-off MMEUS to predict MMPRT+. The prevalence of MMPRT+ was 31.3% (25/80 knees) and 29.1% (16/55 knees) in the non-ROA and ROA groups. The MMEUS of MMPRT+ patients were significantly greater than that of MMPRT– patients in both the non-ROA (5.9 ± 1.4 mm vs. 4.4 ± 1.0 mm, P < 0.001) and ROA (7.8 ± 1.3 mm vs. 6.3 ± 1.3 mm, P < 0.001) groups. ROC curves demonstrated that 5-mm and 7-mm MMEUS were the optimal cut-off values in non-ROA (adjusted odds ratio: 6.280; area under the curve [AUC]: 0.809; P < 0.001) and ROA (adjusted odds ratio: 15.003; AUC: 0.797; P = 0.001) groups. In both early non-radiographic and established radiographic KOA stages, a greater MMEUS was associated with a higher MMPRTMRI prevalence.
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Wang Y, Wei J, Zeng C, Xie D, Li H, Yang T, Ding X, Cui Y, Xiong Y, Li J, Lei G. Association between chondrocalcinosis and osteoarthritis: A systematic review and meta-analysis. Int J Rheum Dis 2019; 22:1175-1182. [PMID: 31058426 DOI: 10.1111/1756-185x.13583] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2017] [Accepted: 03/31/2019] [Indexed: 01/25/2023]
Abstract
AIM To systematically examine the existing literature on the associations between chondrocalcinosis (CC) and osteoarthritis (OA) at different joints, and to quantify such associations through meta-analysis. METHODS PubMed, Embase and Scopus databases were searched through from inception to June 2017. Cohort, case-control or cross-sectional studies were included if they examined the association between CC and OA. Data on the odds ratios (OR) and their 95% confidence intervals (CI) of the prevalence or progression of OA between the CC group and non-CC group with respect to the same joint were extracted. RESULTS A total of 14 studies were identified. Twelve studies were eligible for assessing the association between knee CC and knee OA. The combined data showed a positive association between them (OR = 2.84; 95% CI, 2.12-3.81; P < 0.001). Three studies were eligible for assessing the association between hip CC and hip OA. The data on the OR could only be extracted from one study (OR = 0.92; 95% CI, 0.68-1.24; P = 0.59). Two studies were eligible for assessing the association between hand CC and hand OA, and the data on the OR could only be extracted from one study which reported significant associations between CC and OA at the metacarpophalangeal joint (OR = 4.75; 95% CI, 2.12-10.64; P < 0.001) and the wrist joint (OR = 4.44; 95% CI, 3.56-5.54; P < 0.001). CONCLUSION This study established a strong association between knee CC and knee OA. However, the associations between CC and OA at the hip or hand still remain controversial and warrant further study.
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Affiliation(s)
- Yilun Wang
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Jie Wei
- Health Management Center, Xiangya Hospital, Central South University, Changsha, Hunan, China.,Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Chao Zeng
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Dongxing Xie
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Hui Li
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Tuo Yang
- Health Management Center, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Xiang Ding
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yang Cui
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yilin Xiong
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Jiatian Li
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Guanghua Lei
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan, China
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