Advertisement

Clinical Rheumatology

, Volume 35, Issue 3, pp 771–773 | Cite as

The prevalence of chondrocalcinosis of the symphysis pubis on CT scan and correlation with calcium pyrophosphate dihydrate crystal deposition disease

  • Trusha PatelEmail author
  • Lawrence Ryan
  • Melissa Dubois
  • Guillermo Carrera
  • Keith Baynes
  • Rajeev Mannem
  • Jennifer Mulkerin
  • Alexis Visotcky
Brief Report

Abstract

Calcium pyrophosphate dihydrate (CPP) crystal deposition in the articular cartilage can often be seen radiographically as chondrocalcinosis (CC). CPP crystals preferentially deposit in fibrocartilages such as the knee menisci and symphysis pubis (SP). We sought to determine the prevalence of CC in the SP on computed tomography (CT) of the abdomen and pelvis. This retrospective study involved readings on 1070 consecutive CTs of the abdomen and pelvis performed over 3 months in patients over 65 years of age. Medical records of 226 patients found to have CC were reviewed to determine age, gender, documentation of CPPD on problem lists or in medical histories, and whether radiology readings of the CTs mentioned CC. SP CC was identified in 21.1 % (226/1070) of consecutive CT scans with the mean age of CT+ patients being 78.6. Of the 226 patients with SP CC, the observation of CC was documented in only 5.3 % (12/226) of the radiology reports. Of the 12 instances in which the radiology reports mentioned CC, this observation was never (0/12) transmitted to the medical history or problem list. The prevalence of SP CC in patients older than 65 was 21.1 %. Since the majority of CTs of the abdomen and pelvis are not ordered for evaluation of musculoskeletal conditions, this is likely a true prevalence without selection bias. When CC of the SP was present on images, radiologists routinely overlooked or chose not to report CC. Even in the rare instances when it was reported, that information was not added to the medical history or problem list. There are several clinical situations (e.g., acute monoarthritis or atypical osteoarthritis) in which recognizing that a patient has CPP deposition would be useful. Taking the time to review images may yield clinically important findings that are not mentioned anywhere on the patient chart.

Keywords

Calium pyrophosphate dihydrate crystal deposition disease Chondrocalcinosis CT scan Symphysis pubis 

Notes

Acknowledgments

We would like to acknowledge Dr. Sergey Tarima for his assistance with the statistical analysis.

Compliance with ethical standards

Disclosures

None.

References

  1. 1.
    Zhang W, Doherty M, Bardin T et al (2011) EULAR recommendations for calcium pyrophosphate deposition. Part I: terminology and diagnosis. Ann Rheum Dis 70:563–570CrossRefPubMedGoogle Scholar
  2. 2.
    Zhang W, Doherty M, Pascual E et al (2011) EULAR recommendations for calcium pyrophosphate deposition. Part II: management. Ann Rheum Dis 70:571–575CrossRefPubMedGoogle Scholar
  3. 3.
    Resnick D, Niwayama G, Goergen TG, Utsinger PD, Shapiro RF, Haselwood DH, Wiesner KB (1977) Clinical, radiographic and pathologic abnormalities in calcium pyrophosphate dehydrate deposition disease (CPPD): pseudogout. Radiology 122(1):1–15CrossRefPubMedGoogle Scholar
  4. 4.
    Becker I, Woodley SJ, Stringer MD (2010) The adult human pubic symphysis: a systematic review. J Anat 217:475–487CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Abhishek A, Doherty S, Maciewicz R et al (2012) Chondrocalcinosis is common in the absence of knee involvement. Arthritis Res Ther 14:R205, http://arthritis-research.com/content/14/5/R205 CrossRefPubMedPubMedCentralGoogle Scholar

Further reading

  1. 6.
    Abreu M, Johnson K, Chung CB, De Lima Jr JE, Trudell D, Terkeltaub R, Pe S, Resnick D (2004) Calcification in calcium pyrophosphate dehydrate (CPPD) crystalline deposits in the knee: anatomic, radiographic, MR imaging, and histologic study in cadavers. Skelet Radiol 33(7):392–398CrossRefGoogle Scholar
  2. 7.
    Shirazaian H, Chang E, Wolfson T et al (2014) Prevalence of sternoclavicular joint calcium pyrophosphate dehydrate crystal deposition on computed tomography. Clin Imaging 38:380–383CrossRefGoogle Scholar
  3. 8.
    Ramonda R, Musacchio E, Perissinotto E et al (2009) Prevalence of chondrocalcinosis in Italian subjects from Northeastern Italy. The Pro.V.A (PROgetto Veneto Anziani) study. Clin Exp Rheumatol Online 27:981–984Google Scholar
  4. 9.
    Miksanek J, Rosenthal A (2015) Imaging of calcium pyrophosphate deposition disease. Curr Rheumatol Rep 17:20CrossRefPubMedGoogle Scholar
  5. 10.
    Ryu K, Iriuchishima T, Oshida M et al (2014) The prevalence of and factors related to calcium pyrophosphate dihydrate crystal deposition in the knee joint. Osteoarthr Cartil 22:975–979CrossRefPubMedGoogle Scholar
  6. 11.
    Kenzaka T, Wakabayashi T, Morita Y (2013) Acute crystal deposition arthritis of the pubic symphysis. BMJ Case Rep 2013. Published online: 16, AprilGoogle Scholar
  7. 12.
    McCarty DJ (1976) Calcium pyrophosphate dihydrate crystal deposition disease—1975. [Review] [62 refs]. Arthritis Rheum 19:suppl-85Google Scholar

Copyright information

© International League of Associations for Rheumatology (ILAR) 2016

Authors and Affiliations

  • Trusha Patel
    • 1
    Email author
  • Lawrence Ryan
    • 1
  • Melissa Dubois
    • 2
  • Guillermo Carrera
    • 2
  • Keith Baynes
    • 2
  • Rajeev Mannem
    • 2
  • Jennifer Mulkerin
    • 2
  • Alexis Visotcky
    • 3
  1. 1.Division of RheumatologyFroedtert & Medical College of WisconsinMilwaukeeUSA
  2. 2.Division of RadiologyFroedtert & Medical College of WisconsinMilwaukeeUSA
  3. 3.Medical College of WisconsinMilwaukeeUSA

Personalised recommendations