US appeared to be a helpful tool, possibly better than CR or CT, in revealing CC in patients with CPDD. Informativity of CT and CR in the detection of CC is almost equal.

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BackgroundPotential input of inflammation induced by calcium pyrophosphate crystals into further progression of osteoarthritis (OA) have been widely speculated [1], but casual association between OA progression and calcium pyrophosphate deposition disease (CPPD) development remains unclear.ObjectivesTo compare radiographic progression of knee osteoarthritis between patients with different clinical types of CPPD and patients with OA.MethodsPreliminary data from 2-year prospective study of 120 pts are presented. 76 pts had CPPD (33 m, 43 f) (I group), 44 – knee OA (13 m, 31 f) (II group). Mean age of pts was 60.8±10.7 years in the I group and 62.0±9.4 years in the II group. According to EULAR terminology CPPD patients were grouped into 3 clinical arms: chronic arthritis (n=43), acute arthritis (n=7) and OA with CPPD (n=26). CPPD was diagnosed based on McCarty criteria, OA diagnosis fulfilled ACR criteria. X-ray of the knee joints was performed in all pts in anterior-posterior and lateral projections. Using radiographs of the knees we assessed joint space narrowing, osteophytes, presence of osteosclerosis and cysts in the tibiofemoral (medial and lateral) and patellofemoral compartments. Kellgren and Lawrence (KL) score (0-4) was also determined. Progression was defined as an increase in ≥1 in the radiographic features assessed or total KL score in either knee during follow-up. Routinely were also measured and calculated: body mass index (BMI), WOMAC, self-assessment questionnaire the Lequesne survey, HAQ and pain on VAS. Serum levels of hsCRP were also performedResultsAt baseline pts were comparable by age, BMI, number of affected joints, radiographic stage of knee osteoarthritis, pain level, Womac, Lequesne and HAQ scores. Radiographic progression was observed in 30 (39%) pts in I group and in 10 (22%) pts of the II group (p=0.06). Among pts with different CPPD types radiographic progression was registered in 23 (46%) pts with chronic or acute arthritis and in 7 (27%) with OA with CPPD (p=0.10). Radiographic progression rate in OA with CPPD pts was similar to that in pts with OA (p=0.69), but in pts with chronic or acute arthritis in CPPD this rate was higher than in pts with OA (p=0.018).Mean serum hsCRP level in pts with CPPD and OA was similar (3.98±2.1 mg/l vs 2.52±1.33 mg/l, correspondingly) (p=0.78). Serum hsCRP levels in pts with acute or chronic arthritis in CPPD was higher than in pts with OA (12.32±8,01 mg/l vs 2.52±1.33 mg/l, correspondingly) (p=0.002) and in pts with OA and CPPD (12.32±8.01 mg/l vs 2.16±1.32 mg/l, correspondingly) (p=0.003). Knee replacement surgery was required in 5 (6%) pts with CPPD and in 4 (9%) – with OA (p=0.61).ConclusionsRate of radiographic progression of knee osteoarthritis is comparable between pts with OA and CPPD. Although in pts with acute or chronic arthritis in CPPD radiographic progression of knee osteoarthritis was more significant if compared to OA or OA with CPPD. The potential cause for this discrepancy may be chronic inflammation induced by CPP crystalsReferencesLi...

ObjectiveTo evaluate seasonal patterns of early inflammatory arthritis (IA) onset and potential associations with IA symptom onset.MethodsThe Canadian Early Arthritis Cohort (CATCH) is an inception cohort study of adults with early (12 months or less) IA. We used patient reports of symptom onset as a proxy of IA onset and examined the seasonal distribution of IA onset over 10 years. Influenza time series was based on laboratory‐confirmed influenza A and B from the Canadian FluWatch surveillance from 2010‐2016. Bivariate analysis of influenza and IA was performed using cross‐correlations with different time lags and Poisson regression. IA and influenza were recorded as monthly total frequencies.ResultsOf 2519 IA patients, 88% had confirmed rheumatoid arthritis (RA). Significantly, more IA onsets occurred in winter compared with other seasons (P = 0.03); although IA onset was more frequent in January, the difference between months was not statistically significant. Compared to months with the lowest influenza rates, months with the highest influenza rates had a statistically significant, but trivial, increase of 0.003% in the incidence of IA (incidence rate ratio (95% confidence interval): 1.00003 (1.00005; 1.000053), P = 0.02).ConclusionAlthough IA symptom onset occurs more frequently in winter, we found that flu outbreaks were not associated with a meaningful increase in IA symptom onset in a large, well‐characterized cohort of Canadian adults over 6 years.