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Rare presentation of intradural calcium pyrophosphate dihydrate crystal deposition

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Abstract

Calcium pyrophosphate dihydrate crystal deposition (CPPD), also known as pseudogout, can have spinal manifestations in roughly one quarter of patients. We present a rare, intradural manifestation of CPPD requiring surgical intervention, with a review of pertinent differential diagnoses on imaging. A 48-year-old male presented with urinary retention, and was found to have an intradural lesion with peripheral enhancement on gadolinium T1-weighted magnetic resonance imaging. Due to the patient’s progressive neurological deterioration, he was taken for a minimally invasive approach for resection of the lesion. Histopathological analysis revealed crystal deposits with rhomboidal birefringence consistent with CPPD. The imaging features of this lesion were atypical for any of the traditional intradural extramedullary lesions. Typically seen extradurally, recognizing CPPD as a potential culprit for intradural compression is helpful to recognize for providers.

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Correspondence to Pouya Entezami.

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All procedures performed in the studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Gewolb, D.P., Entezami, P., German, J.W. et al. Rare presentation of intradural calcium pyrophosphate dihydrate crystal deposition. Neuroradiology 63, 1735–1737 (2021). https://doi.org/10.1007/s00234-021-02726-7

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  • DOI: https://doi.org/10.1007/s00234-021-02726-7

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