Calcium Pyrophosphate Deposition Disease Involving a Lumbar Facet Joint Following Urinary Tract Infection

Ujihara, Tetsuro; Yamamoto, Kei; Kitaura, Tsuyoshi; Katanami, Yuichi; Kutsuna, Satoshi; Takeshita, Nozomi; Hayakawa, Kayoko; Ohmagari, Norio

doi:10.2169/internalmedicine.2099-18

Cited by 6 publications

(10 citation statements)

References 11 publications

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“…Intern Med 2019;58:1787–9. 10 2019 Case report (1) Woman, 75 years E. Coli urinary infection Fever and acute low back pain at J8 of Levofloxacin History of kideny stones X-Ray MRI Cartilage calcification of the wrist, knee, shoulder Liquid retention at the lumbar facet joint (L4-L5) without findings compatible with discitis or vertebral osteomyelitis NSAIDs Pain and fever improved No recurrence Mikhael MM, Chioffe MA, Shapiro GS. Calcium Pyrophosphate Dihydrate Crystal Deposition Disease (Pseudogout) of Lumbar Spine Mimicking Osteomyelitis- Discitis With Epidural Phlegmon n.d.:4.…”

Section: Resultsmentioning

confidence: 99%

“… 15 Fever was present in 6 cases. 7 , 10 , 14 , 25 , 27 , 33 In two cases, the symptomatology led to a misdiagnosis of a urinary tract infection. 10 , 27 …”

Section: Resultsmentioning

confidence: 99%

“…NSAIDs were prescribed in 5 cases 7 , 10 , 13 , 16 , 27 with clinical and biological improvement. Colchicine was used in 2 cases and the symptomatology disappeared under treatment.…”

Section: Resultsmentioning

confidence: 99%

“…Among patients with lumbar spine deposits of CPPD, 32 were women. [7][8][9][10][11][12][13][14][15][16][17][18][19][20][21] In the other studies, the epidemiological characteristics such as age and gender were not mentioned, as they concerned histological specimens of operated discs. [3][4][5][6] A history of CPPD was present in 40 patients.…”

Section: Characteristics Of the Patientsmentioning

confidence: 99%

“…-The duration of symptoms varied between one day (acute back pain) 10,14,15,22,[26][27][28] and 8 years. 9 The affection has been discovered during back pain in 22 cases.…”

Section: Duration Of Symptoms and Background Circumstancesmentioning

confidence: 99%

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Lumbar Spinal Involvement in Calcium Pyrophosphate Dihydrate Disease: A Systematic Literature Review

Tekaya¹,

Nacef²,

Bellil³

et al. 2022

IJGM

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Background Calcium-pyrophosphate-dihydrate-disease (CPPD) is a crystal-induced arthropathy. The lumbar-spinal involvement is rare and often under-diagnosed. This study aimed to report the case of a lumbar spine CPPD involvement and to perform a systematic review of clinical, imaging features of lumbar involvement in CPPD patients, and treatments that have been implemented. Methods This systematic review was conducted in accordance with the Preferred-Reporting-Items-for-Systematic-Reviews and Meta-Analyses (PRISMA) guidelines. Results One hundred and sixty-seven articles met the search criteria using electronic databases searches. We retained 28 articles (20 case reports, 2 case series, 1 family survey, 4 retrospective studies, and 1 prospective study) involving a total of 62 patients. The age ranged between 39 and 89 years old. Among patients with lumbar spine CPPD, 32 were women. The duration of symptoms varied between one day and 8 years. The affection has been discovered during back pain in most cases. In 5 studies, the diagnosis was made on histological specimens of patients operated on for another pathology. X-ray showed calcifications in 2 cases. CT-scan detected calcium deposit in 7 cases. MRI showed lesions going from the increased signal of the disk, to calcified or not-cystic lesion of the facet joints, an intramedullary mass mimicking a schwannoma. Histological examination established the diagnosis of CPPD in 21 patients in all studies. Medical treatment included NSAIDs, Colchicine, Interleukin-1-receptor-antagonist, and antibiotics. Surgery was performed on 13 patients and allowed to establish the histological diagnosis. Conclusion In the case of inflammatory back pain in elderly subjects, without an infectious gateway, diagnosis of CPPD should be considered, especially for patients with a history of spinal surgery or degenerative radiography changes. CT scan is more sensitive than conventional radiographs. The discovertebral biopsy is the Gold-Standard and should be performed whenever the diagnosis was uncertain. Treatment includes the medical and surgical components.

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Section: Resultsmentioning

confidence: 99%

“… 15 Fever was present in 6 cases. 7 , 10 , 14 , 25 , 27 , 33 In two cases, the symptomatology led to a misdiagnosis of a urinary tract infection. 10 , 27 …”

Section: Resultsmentioning

confidence: 99%

“…NSAIDs were prescribed in 5 cases 7 , 10 , 13 , 16 , 27 with clinical and biological improvement. Colchicine was used in 2 cases and the symptomatology disappeared under treatment.…”

Section: Resultsmentioning

confidence: 99%

Section: Characteristics Of the Patientsmentioning

confidence: 99%

“…-The duration of symptoms varied between one day (acute back pain) 10,14,15,22,[26][27][28] and 8 years. 9 The affection has been discovered during back pain in 22 cases.…”

Section: Duration Of Symptoms and Background Circumstancesmentioning

confidence: 99%

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