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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

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

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

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

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

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

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

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

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

Acta Orthop Traumatol Turc 2021 Dec;55(6):466-472

Department of Orthopedics and Traumatology, Bezmialem Foundation University, İstanbul, Turkey.

Objective: The aim of this study was to investigate the impact of correction of the reverse shoulder arthroplasty (RSA) angle on clinical outcomes in patients with cuff tear arthropathy (CTA).

Methods: This single-center retrospective study was conducted in patients with CTA treated with RSA between 2013 and 2018. A structured questionnaire collecting demographic data, postoperative follow-up time, pre- and postoperative range of motion (ROM), American Shoulder and Elbow Surgeons (ASES) and Constant functional scores as well as scapular notching according to the Sirveaux Classification and RSA angle were evaluated by independent observers. Read More

Int J Surg Case Rep 2021 Dec 24;89:106622. Epub 2021 Nov 24.

Department of Orthopaedics, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand. Electronic address:

Introduction: Symptomatic retro-odontoid pseudotumor (ROP) caused by cervical compression and myelopathy is rare. Pathological diagnosis is recommended for differential diagnosis including the following: inflammatory disease, primary bone tumor, metastatic disease and calcium pyrophosphate dihydrate deposition (CPPD) also known as "crowned dens syndrome". The authors report a rare case of ROP caused by CPPD deposition combined with multilevel cervical spondylotic myelopathy (MCSM) which was treated by tumor resectioning using a transoral approach combined with posterior decompression and fusion. Read More

Best Pract Res Clin Rheumatol 2021 12 17;35(4):101724. Epub 2021 Nov 17.

Division of Rheumatology, Inflammation and Immunity, Brigham and Women's Hospital, Boston, MA, USA. Electronic address:

This review highlights outcomes for patients with calcium pyrophosphate deposition (CPPD) reported in prior studies and underscores challenges to assessing outcomes of this condition. Prior clinical studies of interventions for CPPD focused on joint damage and calcification on imaging tests, joint pain, swelling, and inflammatory biomarkers. Qualitative interviews with patients with CPPD and healthcare providers additionally identified flares, overall function, and use of analgesic medications as important outcomes. Read More

BMC Musculoskelet Disord 2021 Nov 4;22(1):929. Epub 2021 Nov 4.

Department of Orthopedics and Traumatology, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Rd., Beitou District, Taipei, 11217, Taiwan, Republic of China.

Background: Involvement in cervical ligamentum flavum is a rare manifestation of the calcium pyrophosphate dihydrate deposition disease. Only few cases of this condition have been reported. We revealed eighteen cases of CPPD in cervical ligamentum flavum that diagnosed at a single medical center. Read More

Semin Musculoskelet Radiol 2021 Aug 27;25(4):617-627. Epub 2021 Oct 27.

Department of Radiology, Icahn School of Medicine at Mount Sinai Hospital, New York, New York.

Upper extremity entrapment neuropathies are common and can cause pain, sensory loss, and muscle weakness leading to functional disability. We conducted a retrospective review from January 2007 until March 2020 of the magnetic resonance imaging (MRI) features of intrinsic and extrinsic causes of wrist, forearm, and elbow neuropathies of 637 patients who received a diagnosis of neuropathy by means of clinical and electrodiagnostic testing. We discuss cases with varying intrinsic and extrinsic nerve pathologies, including postoperative examples, affecting the median, radial, and ulnar nerve. Read More

J Orthop Res 2022 Jul 26;40(7):1707-1714. Epub 2021 Oct 26.

Division of Orthopaedics, Department of Development and Regeneration, Institute for Orthopaedic Research and Training (IORT), KU Leuven, University Hospitals Leuven, Leuven, Belgium.

Rotator cuff tear arthropathy (RCTA) is characterized by massive rotator cuff tearing combined with humeral head migration (HHM). The aim of this study is to investigate the quantitative characteristics of this migration and its association with glenoid erosions and prearthropathy scapular anatomy. We quantified HHM and prearthropathy scapular anatomy of 64 RCTA patients with statistical shape modeling-based techniques. Read More

Joint Bone Spine 2022 01 8;89(1):105288. Epub 2021 Oct 8.

Inserm UMR 1125, 1, rue de Chablis, 93017 Bobigny, France; Assistance Publique-Hôpitaux de Paris (AP-HP), Groupe Hospitalier "Hôpitaux Universitaires de Paris-Seine Saint-Denis", Service de Rhumatologie, 125, rue de Stalingrad, 93017 Bobigny, France. Electronic address:

Curr Rheumatol Rep 2021 10 8;23(10):77. Epub 2021 Oct 8.

Division of Rheumatology, Department of Medicine, NYU Grossman School of Medicine, New York, NY, USA.

Purpose Of Review: Calcium pyrophosphate deposition disease (CPPD) arises from calcium pyrophosphate deposition throughout the body, leading to different clinical syndromes that may be diagnosed using various imaging modalities. The purpose of this review is to highlight recent updates in the imaging of CPPD.

Recent Findings: Conventional radiography remains the initial test when imaging CPPD; but musculoskeletal ultrasound and conventional computed tomography (CT) may also assist in diagnosing and characterizing CPP deposits, with increased sensitivity. Read More

N Z Med J 2021 09 3;134(1541):130-133. Epub 2021 Sep 3.

Consultant Physician and Rheumatologist, Whangarei Hospital, New Zealand.

Rheumatology (Oxford) 2022 05;61(6):2494-2503

Université de Paris, INSERM UMR 1132, BIOSCAR, Hôpital Lariboisière, Service de Rhumatologie, Centre Viggo Petersen, DMU Locomotion, APHP.

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 for CC in GS. Read More

Intern Med J 2021 Aug;51(8):1357-1358

Department of Neurosurgery, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.

Reumatismo 2021 Aug 3;73(2):106-110. Epub 2021 Aug 3.

Rheumatology Department, Luigi Sacco University Hospital, Milan.

The aim of this study was to evaluate the accuracy of synovial fluid analysis in the identification of calcium pyrophosphate dihydrate crystals compared to microscopic analysis of joint tissues as the reference standard. This is an ancillary study of an international, multicentre cross-sectional study performed by the calcium pyrophosphate deposition disease (CPPD) subgroup of the OMERACT Ultrasound working group. Consecutive patients with knee osteoarthritis (OA) waiting for total knee replacement surgery were enrolled in the study from 2 participating centres in Mexico and Romania. Read More

Clin Imaging 2021 Dec 26;80:167-179. Epub 2021 Jul 26.

Medical Imaging Center, Department of Radiology, Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.

Facet joints are the important articular pillars of the spine. Several pathologies can occur in and around the facet joint, including extra ossicles, traumatic dislocation, osteoarthritis, synovial cyst, axial spondyloarthritis, rheumatoid arthritis, calcium pyrophosphate deposition disease, septic arthritis, and malignant and benign neoplasms. Imaging is the mainstay to detect and characterize these diseases. Read More

Eur Arch Otorhinolaryngol 2021 Oct 30;278(10):3901-3910. Epub 2021 Jul 30.

ENT Department, Rennes University Medical Center, 35000, Rennes, France.

Introduction: There is no consensus for management of Mild primary hyperparathyroidism (MILD-pHP). Specific management has been suggested by some authors. We have compared the surgical management of the patients with MILD-pHP to those with Classic primary hyperparathyroidism (C-pHP) treated by surgery according to The Fourth International Workshop on pHP. Read More

J Clin Med 2021 Jun 11;10(12). Epub 2021 Jun 11.

Biomedical Research Institute of Malaga (IBIMA), 29010 Malaga, Spain.

Active microcalcification of elastic fibers is a hallmark of pseudoxanthoma elasticum and it can be measured with the assessment of deposition of 18F-NaF using a PET/CT scan at the skin and vascular levels. It is not known whether this deposition changes over time in absence of specific therapy. We repeated in two years a PET/CT scan using 18F-NaF as a radiopharmaceutical in patients with the disease and compared the deposition at skin and vessel. Read More

Sci Rep 2021 06 11;11(1):11947. Epub 2021 Jun 11.

Institute of Earth Sciences, Faculty of Natural Sciences, University of Silesia, Będzińska 60, 41-200, Sosnowiec, Poland.

Senile vertebrates are extremely rare in the fossil record, making their recognition difficult. Here we present the largest known representative of the Late Cretaceous hadrosauriform Gobihadros mongoliensis showing features of cessation of growth indicating attainment of the terminal size. Moreover, this is the first non-avian dinosaur with an age-related pathology recognized as primary calcium pyrophosphate deposition disease indicating its advanced age. Read More

Diagnostics (Basel) 2021 May 21;11(6). Epub 2021 May 21.

Clinic of Internal Medicine III, Hematology, Oncology, Rheumatology and Clinical Immunology, University Hospital of Bonn, 53127 Bonn, Germany.

Clinical differentiation between gout, osteoarthritis (OA), and calcium pyrophosphate deposition disease (CPPD) remains a hurdle in daily practice without imaging or arthrocentesis. We performed a retrospective analysis of consecutive patients with gout, CPPD, and OA at a tertiary rheumatology center. A total of 277 patients were enrolled, with 164 suffering from gout, 76 from CPPD, and 37 from OA. Read More

Eur Radiol 2021 Dec 28;31(12):9436-9445. Epub 2021 May 28.

Department of Radiology, Balgrist University Hospital, University of Zurich, Zurich, Switzerland.

Objectives: To test the diagnostic accuracy of a 3D dual-echo steady-state (DESS) sequence at 7-T MRI regarding the detection of chondral calcific deposits of the knee in comparison to 3-T MRI, using CT as cross-sectional imaging reference standard.

Methods: CT and 7-T MRI (DESS) of knee joints in 42 patients with radiographically known chondrocalcinosis (13 of 42 bilateral) were prospectively acquired for all included patients (n = 55 knee joints). Additionally, 3-T MRI (DESS) was performed for 20 of these 55 knee joints. Read More