Tophaceous Pseudogout in the Index Finger

Abstract

A 53-year-old man presented to our hospital reporting having detected a mass in the right index finger. We excised the mass, which appeared to be derived from the volar plate and had chalky white depositions at the cutting surface. Histological observations revealed chondrometaplasia and calcium pyrophosphate dihydrate crystal traces, although crystals were not evident owing to decalcification. It was diagnosed as tophaceous pseudogout, which predominantly occurs in the temporomandibular joint. Occurrence in the fingers is rare. Although some studies reported postexcision recurrence, no obvious signs of recurrence were observed at 2.5 years' follow-up in the patient in this report.

An Unusual Pathologic Ulna Fracture Induced by Intraosseous Tumoral Calcium Pyrophosphate Dihydrate Crystal Deposition Disease

“… 9 Often located in the temporomandibular joint or paraspinal tissues, the finding of TCPPDCD in the joints of extremities is rare, with only 3 reported cases occurring at the wrist. 10 , 11 Of the documented cases of TCPPDCD, a predilection for women and patients aged between 31 and 86 years old has been seen. 6 Other risk factors include previous traumas or surgery to the affected joint, osteoarthritis, metabolic conditions (hyperparathyroidism, hypothyroidism, hemochromatosis), and familial CPPDCD.…”

Fluorescence identification of arthropathic calcium pyrophosphate single crystals using alizarin red S and a xanthene dipicolylamine ZnIIcomplex

“…3 Rhomboid crystals with a weakly positive birefringence have been generally reported in the synovial fluid or the paraffin section of meniscus specimens obtained from patients with CPPD crystal-induced arthritis. 3,4 Agglomeration of CPPD crystals in the affected areas, or tophaceous pseudogout, was comparatively rare, 5,6 and monosodium urate mono-hydrate (MSU) was also present in some of the cases. 7 Although the rhomboid CPPD or t-CPPD single crystals were frequently found in pseudogout patients, the rod-shaped m-CPPD crystals were also capable of inducing high degrees of inflammation.…”

Test yourself: a 49-year-old lady with a history of chronic left hip pain following a fall twenty months earlier

“…Distinguishing CPPD from common differential diagnoses is important. For example, chondrosarcoma calcification demonstrates a ring and arc pattern, in contrast to CPPD which presents an amorphous or cloud-like pattern [7].…”