Chondrocalcinosis: Sonographic study of the knee

Coari, Giulio; Iagnocco, Annamaria; Zoppini, A

doi:10.1007/bf02208146

Cited by 48 publications

(18 citation statements)

References 14 publications

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“…[6][7][8][9] In this paper we tried to define the US aspect of CPPD calcifications in order to propose ultrasonographic criteria for the differentiation of CPPD deposits and hyperechoic deposits of another nature. We then tried to verify the relationship between the ultrasonographically defined presence of CPPD calcifications in cartilage and periarticular tissues and the presence of CPPD crystals in the synovial fluid and compare the US findings with the radiographic findings.…”

mentioning

confidence: 99%

Diagnosis of calcium pyrophosphate dihydrate crystal deposition disease: ultrasonographic criteria proposed

Frediani

Filippou

Falsetti

et al. 2005

Annals of the Rheumatic Diseases

133

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Objective: To investigate by high frequency ultrasonography the appearance of calcium pyrophosphate dihydrate (CPPD) calcifications, in the most commonly affected sites in CPPD disease, and the relationship between ultrasonographic CPPD deposits and the presence of CPPD crystals in synovial fluid. Methods: Three ultrasonographic patterns of CPPD calcification were identified and 11 patients enrolled. A control group comprised 13 patients with no evidence of CPPD deposits. Synovial fluid was aspirated from all patients and controls and examined for identification of crystals. All patients underwent a standard radiography examination at the same sites investigated by ultrasound. Results: In all patients with ultrasonographically defined CPPD deposits, CPPD crystals were found in the synovial fluid. In two cases, standard radiographic examination did not show evidence of the calcific deposits that were identified by ultrasonography. CPPD crystals were not found in the synovial fluid of controls. In four control group patients, ultrasonography identified calcifications defined as deposits of another nature. Conclusions: The ultrasonographic pattern used in this study for the diagnosis of CPPD disease demonstrated a very high correlation with the presence of CPPD crystals in synovial fluid. Ultrasonography demonstrated a sensitivity and specificity at least equal to that of radiography in identifying CPPD crystal calcifications. U ntil now, the diagnosis of calcium pyrophosphate dihydrate (CPPD) crystal deposition disease has been based mainly on radiographic or microscopic detection of CPPD crystals.Ryan and McCarty proposed several diagnostic criteria for the diagnosis of CPPD crystal deposition disease, 1 based on the premise that CPPD crystals are the specific feature of the disease and including radiographic clues suggested by Resnick et al 2 and Martel et al. 3 According to these criteria, a case is definite if CPPD crystals are demonstrated in tissues or synovial fluid by definite means (for example, chemical analysis) or if crystals are demonstrated by compensated polarised light microscopy and typical calcifications are seen on radiographs. In this last case, if only one of these criteria is found, a probable diagnosis is made.Ultrasound (US) is a very sensitive and specific technique for detecting calcifications of soft tissues, 4 5 but only a few papers have described sonographic evidence of articular and periarticular changes caused by CPPD disease. [6][7][8][9] In this paper we tried to define the US aspect of CPPD calcifications in order to propose ultrasonographic criteria for the differentiation of CPPD deposits and hyperechoic deposits of another nature. We then tried to verify the relationship between the ultrasonographically defined presence of CPPD calcifications in cartilage and periarticular tissues and the presence of CPPD crystals in the synovial fluid and compare the US findings with the radiographic findings. PATIENTS AND METHODSWe enrolled in this study all patients with US evidence of CP...

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mentioning

confidence: 99%

Diagnosis of calcium pyrophosphate dihydrate crystal deposition disease: ultrasonographic criteria proposed

Frediani

Filippou

Falsetti

et al. 2005

Annals of the Rheumatic Diseases

133

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“…49 US is effective also in demonstrating calcium pyrophosphate deposits in chondrocalcinosis (CPPD). In 1995, Coari et al 50 showed the presence of calcification within condylar cartilage in 43 knees of 28 patients with CPPD, results confirmed by Foldes 51 and lately by Sofka et al, 52 who described a case of US-detected meniscal calcification not visualized by conventional radiography. The US criteria for the diagnosis of CPPD deposition were proposed by 2 distinct groups: Grassi et al 44 focused their attention on the different pattern of crystal deposition in gout and CPPD disease, showing that the presence of hyperechoic material within the substance of hyaline cartilage is typical of chondrocalcinosis.…”

Section: Us In Crystal-related Arthropathiesmentioning

confidence: 88%

The Role of Ultrasound in Rheumatology

Iagnocco

Ceccarelli

Perricone

et al. 2011

Seminars in Ultrasound, CT and MRI

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Sensitive imaging tools are needed to assess disease activity, to detect joint damage, to monitor treatment response, and to predict disease outcome in rheumatic diseases. For its advantages in costs and risks, and for its validity, reproducibility, and sensitivity to change, ultrasonography (US) is playing an increasing role in the evaluation of joints in patients with inflammatory and degenerative disorders. US has demonstrated to be sensitive in the detection of early bone erosions as well as in the depiction of soft-tissue damage. Semin Ultrasound

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“…Over the last decade US has been used increasingly for the diagnosis of CPPD in the joints, and the main US findings have been described extensively by us and other authors [1–8]. The main US landmark of the disease is the presence of hyperechoic deposits, not creating posterior shadowing, in the hyaline cartilage and in the fibrocartilage of joints (menisci, triangular fibrocartilage of the wrist) (Figure 1).…”

Section: Discussionmentioning

confidence: 99%

“…Over the last decade, ultrasonography (US) has been demonstrated to be an excellent technique for detecting calcium pyrophosphate dihydrate (CPP) crystal deposits in joints and periarticular tissues [1–8], and the aspect of these deposits in hyaline cartilage and fibrocartilage has been described (Figure 1). In the literature the sensitivity of US in identifying CPP crystal deposits varies between a minimum of 15% [3] for the plantar fascia and a maximum of 89% [7] for the hyaline cartilage of the knee.…”

Section: Introductionmentioning

confidence: 99%

Do Not Hallow until You Are out of the Wood! Ultrasonographic Detection of CPP Crystal Deposits in Menisci: Facts and Pitfalls

Filippou

Adinolfi

Bozios

et al. 2013

The Scientific World Journal

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Purpose. Ultrasonography (US) has been demonstrated to be an important tool in the diagnosis of calcium pyrophosphate (CPP) crystal deposition disease. The aim of our study was to individuate and describe possible pitfalls in US detection of such deposits in menisci. Patients and Methods. We enrolled all patients waiting to undergo knee replacement surgery due to osteoarthritis, for one-month period. Each patient underwent US examination of the knee, focusing on the menisci. After surgery, the menisci were examined by US, macroscopically and microscopically, using the microscopic analysis as the gold standard for CPP deposition. Results. 11 menisci of 6 patients have been studied. Ex vivo examination of menisci performed better in CPP identification than in vivo examination. The possible reasons of misinterpretation or misdiagnosis of the in vivo exam were identified and are extensively described in the paper. Also a new sign of CPP crystal deposits was found. Conclusions. This study permitted to highlight some difficulties in CPP crystal detection by US in menisci. Further studies are needed to define completely US CPP crystal aspect and to improve the sensibility and specificity of US in CPP deposition diagnosis.

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Chondrocalcinosis: Sonographic study of the knee

Cited by 48 publications

References 14 publications

Diagnosis of calcium pyrophosphate dihydrate crystal deposition disease: ultrasonographic criteria proposed

Diagnosis of calcium pyrophosphate dihydrate crystal deposition disease: ultrasonographic criteria proposed

The Role of Ultrasound in Rheumatology

Do Not Hallow until You Are out of the Wood! Ultrasonographic Detection of CPP Crystal Deposits in Menisci: Facts and Pitfalls

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