Trauma Induced Calcium Pyrophosphate Deposition Disease of the Lumbar Spine

Abstract

Inflammatory arthritis, such as pseudogout or otherwise referred to as calcium pyrophosphate (CPP) crystal arthritis or calcium pyrophosphate deposition (CPPD) disease, is characterized by the deposition of crystal formation and deposition in large joints. CPPD is known to affect the elderly population and commonly manifests as inflammation of knees, hips, and shoulders. CPPD disease involving the spine has been infrequently encountered in practice and rarely described in the literature. Here, we describe a case of an 80-year-old female with no known history of inflammatory arthritis who presented with left lower extremity weakness and fall, initially thought to have discitis, later confirming CPPD of the spine through biopsy and ultimately resolution of symptoms with anti-inflammatory agents. Although consisting of different clinical presentations, two other case reports have described CPPD of the spine with similar radiographic findings, to this author’s knowledge. With the radiologic similarities, this unique case serves to raise awareness in the medical community and possibly place pseudogout of the spine on the differential list when such cases are encountered. As a result, patients can be initiated on benign anti-inflammatory agents, avoiding invasive testing and unnecessary antibiotic exposure.

Calcium pyrophosphate deposition disease of the cervical and thoracolumbar spine: A report of two cases

“…However, it is unclear what role these previous surgeries had in the development of CPPD. Although local trauma is a known risk factor for CPPD [39][40][41][42], our patient presented eight years after his previous spine surgeries. Ogawa et al reported the first case of acute lumbar spinal pseudogout occurring four weeks after spinal instrumentation [39] .…”

Cervical vertebrae affection in calcium pyrophosphate crystal deposition disease (description of a clinical case)

“…В работе I. Greca и соавт. [20] описан случай прогрессирующей боли в спине, возникшей у 80-летней женщины через год после травмы позвоночника при падении с лестницы, с последующим развитием острого дисцита, связанного с отложениями кристаллов ПФК (диагноз БДПК был подтвержден данными биопсии). При этом иных локализаций ХК у пациентки не выявлено, сывороточные уровни СРБ и СОЭ были в пределах нормы, а содержание парагормона, щелочной фосфатазы, магния не определяли.…”

Histopathologische Differenzialdiagnostik von Kristall-Arthritiden

“…Arthritiden sind durch intrasynoviale Kristall-Depositionen von zumeist metabolischen Produkten verursacht und sind mit einer floriden oder aber auch chronischen Entzündung assoziiert. Die wichtigsten histopathologisch dia- gnostizierbaren Kristallarthropathien umfassen: Die Gicht, die Chondrocalcinose, die Kalzinose-Arthropathien und die Oxalose [4]. Bei der letzteren Erkrankung handelt es sich um eine Erkrankung, welche in erster Linie im Nierenparenchym sowie im Knochengewebe und selten im Bereich der Gelenke lokalisiert ist.…”