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RMD Open 2022 Jun;8(2)

Ruhr University Bochum, Bochum, Germany

Background: The crystal-induced calcium pyrophosphate deposition disease (CPPD) clinically appearing as pseudogout differs from the mere radiographic finding of chondrocalcinosis (CC) but may cause symptoms resembling rheumatoid arthritis (RA).

Objective: To study the prevalence of CPPD and CC in rheumatic diseases focusing on differences between seropositive and seronegative RA.

Patients And Methods: In a retrospective study design, we analysed records and radiographs of consecutive new patients presenting to our centre between January 2017 and May 2020. Read More

IDCases 2022 6;29:e01526. Epub 2022 Jun 6.

University of Vermont Medical Center, Burlington, VT and Assistant Professor of Medicine at Larner College of Medicine at the University of Vermont, Burlington, VT, USA.

The authors report the case of a 45-year-old male with history of human immunodeficiency virus who presented unresponsive and with injuries to his hands after spending a night on a lakeside beach. During his hospitalization, he developed a fever with arthralgias and was initially thought to have calcium pyrophosphate dihydrate crystal deposition disease before a diagnosis of Rat Bite Fever was ultimately discovered. He was successfully treated with six-weeks of ceftriaxone. Read More

Radiol Clin North Am 2022 Jul;60(4):641-656

Department of Radiology, Medical University Innsbruck, Anichstrasse 35 A-6020, Innsbruck, Austria.

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. Read More

Ann Rheum Dis 2022 May 25. Epub 2022 May 25.

Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital, Boston, Massachusetts, USA.

Objectives: Calcium pyrophosphate deposition (CPPD) disease, broadly defined, has been associated with increased risk of cardiovascular (CV) events. We investigated risk of CV events in patients with acute CPP crystal arthritis, the acute manifestation of CPPD.

Methods: Cohort study using Mass General Brigham electronic health record (EHR) data, 1991-2017. Read More

Reumatol Clin (Engl Ed) 2022 May;18(5):286-292

Servicio de Reumatología, Hospital J. M. Ramos Mejia, Urquiza 609, Ciudad Autónoma de Buenos Aires, Argentina.

Background: Off-label (OL) drug use is the prescription of a drug for indications other than those authorised in its technical datasheet. The objective of this study was to identify drugs recommended in rheumatology but considered for off-label use in Argentina.

Methods: A list of medications for certain selected rheumatic conditions was compiled. Read More

Front Surg 2022 26;9:797495. Epub 2022 Apr 26.

Department of Neurosurgery, University of Tübingen, Tübingen, Germany.

Background: 'Crowned dens syndrome' (CDS) is a special form of calcium pyrophosphate dihydrate deposition disease which is characterized radiologically by a halo-like or crown-like distribution in the periodontoid region and clinically by cervical pain. Herein, we will describe our experience of posterolateral epidural supra-C2-root approach (PESCA) for biopsy of retro-odontoid lesions in one surgical session after occipitocervical fixation and decompression in a patient with CDS and massive brainstem compression.

Case Presentation: A 70-year-old woman presented to our department with a 4-week history of progressive walking impairment, neck pain, neck rigidity, fever, dizziness, slight palsy of the left hand, and multiple fall episodes. Read More

Cureus 2022 Apr 6;14(4):e23902. Epub 2022 Apr 6.

Infectious Disease, Howard University Hospital, Washington, DC, USA.

Severe acute respiratory syndrome coronavirus 2 infection has been a global public health crisis for the past two years. Vaccination has been a mainstay preventive approach among other strategies such as hand washing, social distancing, and wearing facemasks. Here, we present a case of concomitant calcium pyrophosphate deposition disease flare and septic arthritis of the right knee following coronavirus disease 2019 (COVID-19) booster vaccination in a 69-year-old African American male who presented with a painful swollen right knee with associated fever, chills, and rigors three days post-vaccination. Read More

J Gen Fam Med 2022 May 23;23(3):193-194. Epub 2022 Jan 23.

Department of General Internal Medicine Akashi Medical Center Hyogo Japan.

The image shows calcium pyrophosphate deposition disease-induced facet joint arthritis in a Japanese female. In this case, an extremely small fluid specimen meant it was not possible for a full analysis set, but gram stain and culture allowed correct diagnosis. The patient was successfully treated with celecoxib. Read More

Am J Phys Med Rehabil 2022 Apr 15. Epub 2022 Apr 15.

H. Ben Taub Dept of Physical Medicine & Rehabilitation, Baylor College of Medicine, Houston, Texas, U.S.A.

Arthritis Care Res (Hoboken) 2022 Apr 19. Epub 2022 Apr 19.

Department of Academic Rheumatology, University of Nottingham, Nottingham, United Kingdom.

Objectives: To develop definitions for imaging features being considered as potential classification criteria for calcium pyrophosphate deposition (CPPD) disease, additional to clinical and laboratory criteria, and to compile example images of CPPD on different imaging modalities.

Methods: The ACR/EULAR CPPD classification criteria Imaging Advisory Group (IAG) and Steering Committee drafted definitions of imaging features that are characteristic of CPPD on conventional radiography (CR), conventional computed tomography (CT), dual-energy CT (DECT), and magnetic resonance imaging (MRI). An anonymous expert survey was undertaken by a 35-member Combined Expert Committee including all IAG members. Read More

Rheumatology (Oxford) 2022 Apr 12. Epub 2022 Apr 12.

Dept. Biomedical Data Sciences, Section Molecular Epidemiology, Leiden University Medical Center, Leiden (LUMC), The Netherlands.

Objectives: To study the mechanism by which the readthrough mutation in TNFRSF11B encoding OPG-XL, previously shown to affect binding between OPG and heparan sulphate (HS) causes the characteristic bidirectional phenotype of subchondral bone turnover accompanied by cartilage mineralization in CCAL1 chondrocalcinosis patients.

Methods: OPG-XL was studied by human induced pluripotent stem cells expressing OPG-XL and two isogenic CRISPR/Cas9-corrected controls in cartilage and bone organoids. Osteoclastogenesis was studied with monocytes from OPG-XL carriers and matched healthy controls followed by gene expression characterization. Read More

JBJS Case Connect 2022 04 6;12(2). Epub 2022 Apr 6.

Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan.

Case: A 77-year-old man with an acromioclavicular joint ganglion cyst with cuff tear arthropathy had a large mass in the left shoulder. Arthroscopic distal clavicle resection successfully relieved his symptoms without loss of shoulder function by enlargement of the bypass between the cyst and subacromial space through the acromioclavicular joint.

Conclusion: Arthroscopic distal clavicle resection can remove a 1-way check valve in a minimally invasive manner. Read More

Diagnostics (Basel) 2022 Mar 7;12(3). Epub 2022 Mar 7.

Department of Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo, Tokyo 113-8549, Japan.

Calcium pyrophosphate dihydrate (CPPD) deposition disease is a benign disorder characterized by acute gouty arthritis-like attacks and first reported by McCarty. CPPD deposition disease rarely occurs in the temporomandibular joint (TMJ), and although confirmation of positive birefringence by polarized light microscopy is important for diagnosis, it is not reliable because other crystals also show birefringence. We reported a case of CPPD deposition disease of the TMJ that was diagnosed by chemical analysis. Read More

Pain Physician 2022 03;25(2):E319-E329

Division of Rheumatology, Allergy, Immunology, Massachusetts General Hospital, Harvard Medical School, Boston, MA.

Background: Medial knee pain is a common complaint in the adult population. When conservative measures fail, intraarticular knee corticosteroid injections are often offered through the superolateral approach into the suprapatellar recess to provide short-term relief. However, some patients fail to respond and require alternative approaches. Read More

Pol J Radiol 2022 20;87:e93-e112. Epub 2022 Feb 20.

Department of Radiology, University of New Mexico School of Medicine, Albuquerque, New Mexico, USA.

Magnetic resonance imaging (MRI) is extremely useful in the early diagnosis of rheumatologic diseases, as well as in the monitoring of treatment response and disease progression to optimize long-term clinical outcomes. MRI is highly sensitive and specific in detecting the common findings in rheumatologic diseases, such as bone marrow oedema, cartilage disruption, articular erosions, joint effusions, bursal effusions, tendon sheath effusions, and synovitis. This imaging modality can demonstrate structural changes of cartilage and bone destruction years earlier than radiographs. Read More

Am J Case Rep 2022 Mar 12;23:e934833. Epub 2022 Mar 12.

Plastic and Reconstructive Surgery Unit, Padua University Hospital, Padua, Italy.

BACKGROUND Calcium pyrophosphate dihydrate deposition disease includes a variety of clinical syndromes, including acute calcium pyrophosphate (CPP) crystal arthritis. Most patients with CPP crystal arthritis have a primary/idiopathic form presenting with severe pain, swelling, and stiffness. COVID-19 infection, which originated in China in December 2019, required extraordinary efforts to develop and test new vaccines to halt the pandemic. Read More

Int J Mol Sci 2022 Feb 26;23(5). Epub 2022 Feb 26.

School of Medical Laboratory Science and Biotechnology, College of Medical Science and Technology, Taipei Medical University, Taipei 11031, Taiwan.

Calcium pyrophosphate (CPP) deposition disease (CPPD) is a form of CPP crystal-induced arthritis. A high concentration of extracellular pyrophosphate (ePPi) in synovial fluid is positively correlated with the formation of CPP crystals, and ePPi can be upregulated by ankylosis human (ANKH) and ectonucleotide pyrophosphatase 1 (ENPP1) and downregulated by tissue non-specific alkaline phosphatase (TNAP). However, there is currently no drug that eliminates CPP crystals. Read More

J Surg Case Rep 2022 Mar 7;2022(3):rjac055. Epub 2022 Mar 7.

Division of Oral and Maxillofacial Surgery, Department of Reconstructive Oral and Maxillofacial Surgery, School of Dentistry, Iwate Medical University.

Pseudogout is a disease characterized by calcium pyrophosphate crystal deposition. Involvement of the temporomandibular joint (TMJ) is rare. We herein report a case of tophaceous pseudogout of the TMJ with cranial extension. Read More

Biomedicines 2022 Feb 14;10(2). Epub 2022 Feb 14.

Department of Translational Medical Science University of Campania "Luigi Vanvitelli", Via Pansini, Bldg 17, 80131 Naples, Italy.

Vascular calcification (VC) is a pathological event caused by the unusual deposition of minerals in the vascular system, representing the leading cause of cardiovascular mortality in chronic kidney disease (CKD). In CKD, the deregulation of calcium and phosphate metabolism, along with the effect of several uremic toxins, act as key processes conveying altered mineralization. In this work, we tested the ability of lanthionine, a novel uremic toxin, to promote calcification in human endothelial cell cultures (Ea. Read More

Clin Rheumatol 2022 Jun 17;41(6):1817-1824. Epub 2022 Feb 17.

College of Medicine, University of Arizona, 475 N 5th street, Phoenix, AZ, 85031, USA.

This cross-sectional study aims to evaluate the predictors, outcomes, and resource utilization of total knee arthroplasty (TKA) in calcium pyrophosphate deposition disease (CPPD) patients. We used the US National Inpatient Sample database to identify CPPD and non-CPPD who underwent TKA from 2006 to 2014. Data collection included patient demographics and comorbidities. Read More

Ann Med Surg (Lond) 2022 Feb 29;74:103275. Epub 2022 Jan 29.

Medical Resident at Pediatric Ophthalmology Department, Ho^pital 20, Aou^t, 1953, Casablanca, Morocco.

Introduction: Sclerochoroidal calcifications is a rare condition corresponding to senile plaques due to the deposition of calcium and phosphate in the sclera and choroid. It is an elderly patient's pathology. In most cases, it is idiopathic. Read More

Curr Rheumatol Rep 2022 02 10;24(2):40-45. Epub 2022 Feb 10.

Research Division, cc-117, Zablocki VA Medical Center, 5000 W. National Ave, Milwaukee, WI, 53295-1000, USA.

Objectives: Arthritis is a common clinical manifestation of hereditary hemochromatosis (HH), and HH is one of a handful of conditions linked to calcium pyrophosphate deposition (CPPD) in joints. The connection between these two types of arthritis has not yet been fully elucidated. In light of new pathogenic pathways recently implicated in CPPD involving bone, we reviewed the literature on the etiology of hemochromatosis arthropathy (HHA) seeking shared pathogenic mechanisms. Read More

Rheumatol Ther 2022 Apr 2;9(2):379-389. Epub 2022 Feb 2.

Rheumatology Clinic, Department of Internal Medicine, Medical School, University of Ioannina, 45110, Ioannina, Greece.

Coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a matter of concern worldwide and a huge challenge for rheumatologists. Indeed, several antirheumatic drugs are currently used at different stages of COVID-19, such as several cytokine inhibitors and colchicine. Colchicine is one of the oldest medicines with potent anti-inflammatory properties. Read More

Rheumatology (Oxford) 2022 Feb 1. Epub 2022 Feb 1.

Rheumatology Unit, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, Ancona, Italy.

Objective: To explore the spectrum of articular and peri-articular ultrasound (US) findings at metacarpophalangeal (MCP) joints in calcium pyrophosphate (CPP) deposition disease (CPPD).

Methods: Consecutive CPPD patients (chronic CPP crystal inflammatory arthritis or osteoarthritis (OA) with CPPD), and age- and sex-matched controls with rheumatoid arthritis (RA) were prospectively enrolled. Patients underwent bilateral US examination of MCP joints. Read More

J Mater Chem B 2022 02 16;10(7):1055-1062. Epub 2022 Feb 16.

State Key Laboratory of Natural Medicine, The School of Basic Medical Sciences and Clinical Pharmacy, China Pharmaceutical University, Nanjing, Jiangsu 211198, China.

Inorganic pyrophosphate (PPi), as a biologically active anion, is closely related to physiological activities and several pathological changes. Here, we reported a luminescent nanoprobe for the detection and imaging of PPi based on lanthanide nanoparticles with luminescence at the second near-infrared window modified by the tannic acid and Fe complex. A light-harvesting complex was formed after the coordination of colorless tannic acid with Fe and the luminescence of the nanoparticles was quenched through the inner-filter effect. Read More

BMJ Case Rep 2022 Jan 17;15(1). Epub 2022 Jan 17.

The Kellgren Centre for Rheumatology, Manchester University NHS Foundation Trust, Manchester, UK.

Hereditary haemochromatosis (HH) is the most commonly identified genetic disorder in Caucasians. HH has a wide variety of clinical manifestations. As such, the presenting complaint in new diagnoses of HH can be non-specific such as fatigue; however, joint symptoms such as arthralgia are also common. Read More

Curr Opin Rheumatol 2022 03;34(2):103-110

MabLab UR4490, University Lille, ULCO.

Purpose Of Review: To give an overview of what can reasonably be considered as known about dual-energy computed tomography (DECT) in crystal-related arthropathies, and what still needs to be explored.

Recent Findings: Recent studies suggest an overall superiority of DECT over ultrasound in gout in terms of sensitivity (89 vs. 84%) and specificity (91 vs. Read More

Int J Mol Sci 2021 Dec 31;23(1). Epub 2021 Dec 31.

Laboratory and Service of Rheumatology, GIGA Research, Centre Hospitalier Universitaire de Liège, University of Liège, 4000 Liège, Belgium.

An inflamed synovial membrane plays a major role in joint destruction and is characterized by immune cells infiltration and fibroblast proliferation. This proteomic study considers the inflammatory process at the molecular level by analyzing synovial biopsies presenting a histological inflammatory continuum throughout different arthritis joint diseases. Knee synovial biopsies were obtained from osteoarthritis (OA; n = 9), chronic pyrophosphate arthropathy (CPPA; n = 7) or rheumatoid arthritis (RA; n = 8) patients. Read More

Neurospine 2021 Dec 31;18(4):903-913. Epub 2021 Dec 31.

Department of Orthopedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.

The retro-odontoid pseudotumor is often concurrent with atlantoaxial subluxation (AAS). Therefore, the pseudotumor is relatively common in rheumatoid arthritis (RA) but rare in primary osteoarthritis (OA). This is a case report of an elderly male patient suffering from neck pain and compression myelopathy caused by the craniocervical pseudotumor with OA but without atlantoaxial instability. Read More