Calcification in calcium pyrophosphate dihydrate (CPPD) crystalline deposits in the knee: anatomic, radiographic, MR imaging, and histologic study in cadavers

Abreu, Marcelo Rodrigues de; Johnson, Kristen; Chung, Christine B.; Souza-Lima, José Edmilson de; Trudell, Debra; Terkeltaub, Robert; Pe, Shen; Resnick, Donald

doi:10.1007/s00256-004-0767-9

Cited by 99 publications

(63 citation statements)

References 7 publications

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“…We did not perform histologic correlation to confirm the presence of the calcifications. However, the accuracy of radiography in depicting calcifications in soft tissues is well accepted, and this technique has been used as a reference in several studies in the past (1,(12)(13)(14)25). Our study was performed with the menisci at room temperature instead of body temperature, which might have resulted in underestimation of the T2* values, considering that T2* linearly increases with temperature (27).…”

Section: Technical Developments: 30-t Mr Imaging Techniques For Assementioning

confidence: 79%

“…Although magnetic resonance (MR) imaging is the noninvasive technique of choice for the evaluation of knee, and more specifically meniscal, disease, it does not allow facile identification of meniscal calcifications (13,14). This is due in part to a lack of contrast between the meniscal tissue and calcifications, both of which are hypointense on images obtained with clinical sequences because of their relatively short intrinsic T2 relaxation times (13).…”

Section: Meniscal Specimens and Imaging Techniquementioning

confidence: 99%

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Meniscal Calcifications: Morphologic and Quantitative Evaluation by using 2D Inversion-Recovery Ultrashort Echo Time and 3D Ultrashort Echo Time 3.0-T MR Imaging Techniques—Feasibility Study

Omoumi

Bae²,

Du³

et al. 2012

Radiology

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Purpose:To assess the ability of ultrashort echo time (UTE) magnetic resonance (MR) imaging techniques to enable morphologic assessment of different types of meniscal calcifications, to compare these sequences with standard clinical sequences, and to perform T2* measurements of meniscal calcifications. Materials and Methods:This study was exempted by the institutional review board, and informed consent was not required. Results:The two globular calcifications were visualized with all sequences. For punctate (n = 21) and linear (n = 21) calcifications, respectively, visibility rates were as follows: 9.5% for both with the T1-weighted FSE sequence, 0% for both with the T2-weighted FSE sequence, 19.0% and 23.8% with the PD-weighted FSE sequence, 0% for both with the 2D IR UTE sequence, 100% for both with the 3D UTE sequence, and 100% for both with the 3D FSPGR sequence. T2* values were significantly lower for calcifications than for the surrounding meniscal tissue (P , .001). There was a trend of globular calcifications having lower T2* values than other morphologies (P = .08). With the 2D IR UTE technique, the T2* of the globular calcifications tended to be lower than with the 3D UTE technique (0.13-0.16 vs 1.32-3.03 msec) (P = .14, analysis of variance). Conclusion:UTE MR imaging sequences may allow morphologic as well as quantitative evaluation of meniscal calcifications.q RSNA, 2012

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Section: Technical Developments: 30-t Mr Imaging Techniques For Assementioning

confidence: 79%

Section: Meniscal Specimens and Imaging Techniquementioning

confidence: 99%

Meniscal Calcifications: Morphologic and Quantitative Evaluation by using 2D Inversion-Recovery Ultrashort Echo Time and 3D Ultrashort Echo Time 3.0-T MR Imaging Techniques—Feasibility Study

Omoumi

Bae²,

Du³

et al. 2012

Radiology

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“…Currently, radiography is the standard imaging modality to monitor chondrocalcinosis. However, Abreu et al demonstrated using histological correlation, that frequency and location of calcifications within the knee joint can be determined with MR imaging [34], yet this study was limited by the number of specimens included (N = 10). To the best of our knowledge, no structured evaluation of presence and distribution of CaCs in the knee, as well as association with joint degeneration has been performed yet using MRI in a larger cohort.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Chondrocalcinosis and Associated Knee Joint Degeneration Using MR Imaging: Data from the Osteoarthritis Initiative

et al. 2016

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Objectives To evaluate the ability of different MRI sequences to detect chondrocalcinosis within knee cartilage and menisci, and to analyze the association with joint degeneration. Methods Subjects with radiographic knee chondrocalcinosis (n = 90, age 67.7 ± 7.3 years, 50 women) were selected from the Osteoarthritis Initiative and matched to controls without radiographic chondrocalcinosis (n = 90). Visualization of calcium-containing crystals (CaC) was compared between 3D T1-weighted gradient-echo (T1GE), 3D dual echo steady-state (DESS), 2D intermediate-weighted (IW), and proton density (PD)-weighted fast spin-echo (FSE) sequences obtained with 3T MRI and correlated with a semiquantitative CaC score obtained from radiographs. Structural abnormalities were assessed using Whole-Organ MRI Score (WORMS) and logistic regression models were used to compare cartilage compartments with and without CaC. Results Correlations between CaC counts of MRI sequences and degree of radiographic calcifications were highest for GE (r T1GE = 0.73, P < 0.001; r DESS = 0.68, P < 0.001) compared to other sequences (P > 0.05). Meniscus WORMS was significantly higher in subjects with chondrocalcinosis compared to controls (P = 0.005). Cartilage defects were significantly more frequent in compartments with CaC than without (patella: P = 0.006; lateral tibia: P < 0.001; lateral femur condyle: P = 0.017). Conclusions Gradient-echo sequences were most useful for the detection of chondrocalcinosis and presence of CaC was associated with higher prevalence of cartilage and meniscal damage.

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“…As with previously reported cases [8,10], there were no specific imaging features that identified malignant change. The remaining cases (Charcot joint, crystal arthropathy, synovial chondroma, exostosis, loose body and synovial haemangioma) are also well recognised as being associated with periarticular calcification or ossification [3,[11][12][13][14] and are more uncommon but merit inclusion in the differential diagnosis. Bone erosion was present in 20 cases.…”

Section: Discussionmentioning

confidence: 99%

Characterisation of intra-articular soft tissue tumours and tumour-like lesions

Adams

Saifuddin

2006

Eur Radiol

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The aim of this study was to describe a new magnetic resonance imaging (MRI) classification system for intra-articular soft tissue tumours based on the morphology of the lesion, with the aim to aid the differential diagnosis. We performed a retrospective review of 52 consecutive patients presenting to a specialist musculoskeletal oncology unit with a suspected intra-articular tumour. Lesions were categorised into one of four groups according to a simple classification system based on their morphological features on MRI. Distinct groupings of pathologies emerged corresponding to each of the morphological categories. Particularly when combined with radiographic features of calcification and bone erosion, certain patterns were found to be characteristic of specific diagnoses. For example multifocal, calcified lesions were found exclusively in synovial osteochondromatosis and diffuse synovitis with hypointense T2-weighted signal intensity was typical of pigmented villonodular synovitis. Certain combinations of imaging features such as diffuse solid lesions and focal lesions with bone erosion were commonly associated with malignant lesions. We suggest that by classifying intra-articular masses according to their morphological features on MRI, particularly when combined with simple radiographic features, an additional parameter may be generated to aid the radiologist in making a diagnosis. In addition, particular combinations of features provide 'red flags' to increase the index of suspicion for malignancy.

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Calcification in calcium pyrophosphate dihydrate (CPPD) crystalline deposits in the knee: anatomic, radiographic, MR imaging, and histologic study in cadavers

Cited by 99 publications

References 7 publications

Meniscal Calcifications: Morphologic and Quantitative Evaluation by using 2D Inversion-Recovery Ultrashort Echo Time and 3D Ultrashort Echo Time 3.0-T MR Imaging Techniques—Feasibility Study

Meniscal Calcifications: Morphologic and Quantitative Evaluation by using 2D Inversion-Recovery Ultrashort Echo Time and 3D Ultrashort Echo Time 3.0-T MR Imaging Techniques—Feasibility Study

Evaluation of Chondrocalcinosis and Associated Knee Joint Degeneration Using MR Imaging: Data from the Osteoarthritis Initiative

Characterisation of intra-articular soft tissue tumours and tumour-like lesions

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