Bilateral Olecranon Bursitis – A Rare Clinical presentation of Calcium Pyrophosphate Crystal Deposition Disease

Abstract

Introduction:Calcium pyrophosphate crystal deposition disease (CPPD) is the most common form of crystal arthropathy second only to gout. Common clinical presentation is an acute monoarticular arthritis commonly occurring in knee joints. We presented a case of bilateral olecranon bursitis in a calcium pyrophosphate crystal deposition disease.Case Report:A 42-year-old female patient is presented with golf ball sized painless swellings in the posterior aspect of her elbows. Elbow joints were clinically normal except for restriction of terminal flexion. X-ray showed mild erosion at the tip of olecranon. Excision biopsy of the swelling showed positive birefringent calcium pyrophosphate dehydrate crystals on the inner wall of the specimen on polarized light microscopy.Conclusion:Bilateral olecranon bursitis may be part of the extraarticular manifestations of calcium pyrophosphate dihydrate crystal deposition disease with good prognosis following in toto bursa excision.

Bicipitoradial bursitis: A diagnosis challenge!

“…Isolated bursitis is uncommon. 13 This diagnosis requires demonstration of CPP crystals. 14 Familial CPPD disease and risk factors of CPPD (hyperparathyroidism, hypomagnesemia, gout, hemochromatosis, hypothyroidism, and hypophosphatasia) should be considered in young patients such in our case.…”

“…Although CCPD typically targets the articular structures, periarticular involvement, including the tendons and bursae, can occur. Isolated bursitis is uncommon 13 …”

Bilateral Olecranon Tophaceous Gout Bursitis

“…The olecranon bursa is very commonly involved in tophaceous gout because of the tendency of monosodium urate crystals to deposit in superficial structures with low temperatures [5]. But however bilateral olecranon tophaceous gout is very rare [4]. Chronic gout often causes boney erosions, which lead to debilitating joint damage.…”

“…On the other hand, there can be unusual presentations associated with chronic gout. Presentation with bilateral olecranon chronic tophaceous gout was reported very rarely [4]. …”

The EFSUMB Guidelines and Recommendations for Musculoskeletal Ultrasound – Part I: Extraarticular Pathologies

“…Despite its superficiality, few reports about the US appearance of the olecranon bursae have been published 175 176 . The olecranon bursa is very commonly involved in tophaceous gout 177 178 and rarely in calcium pyrophosphate dihydrate crystal deposition disease 179 .…”