Spinal involvement with calcium pyrophosphate deposition disease in an academic rheumatology center: A series of 37 patients

Moshrif, A.; Laredo, J. D.; Bassiouni, Hassan; Abdelkareem, Mohamed; Richette, Pascal; Rigon, Matthieu Reshe; Bardin, Thomas

doi:10.1016/j.semarthrit.2018.10.009

Cited by 54 publications

(64 citation statements)

References 45 publications

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“…A number of cases of CPDD affecting the spine have been described in the literature, but most reports include one or few cases, which suggests that CPDD requiring surgery is relatively unfrequent. This is in contrast with the finding of high prevalence (as high as 25%) of deposits of calcium pyrophosphate in the cervical spine of patients with pseudogout affecting peripheral joints [2] .…”

contrasting

confidence: 82%

Spinal pseudogout is a joker. Commentary on “Calcium pyrophosphate deposition disease of the cervical and thoracolumbar spine: A report of two cases”

Vanni

Berjano

2020

North American Spine Society Journal (NASSJ)

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contrasting

confidence: 82%

Spinal pseudogout is a joker. Commentary on “Calcium pyrophosphate deposition disease of the cervical and thoracolumbar spine: A report of two cases”

Vanni

Berjano

2020

North American Spine Society Journal (NASSJ)

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“…Similarly, in our cases, the lesion appeared to be located in the middle-to-posterior portion of the spinal canal at the C3 and C4 level, and it compressed the spinal cord posteriorly from the bases of C3 and C4 laminae [ 1 ]. On MRI, CPPD deposition manifests as a predominately hypointense area on T1 and T2 weighted images, as in the present cases [ 3 , 24 , 25 ]. Moreover, MRI is also useful to assess spinal cord compression or myelopathy [ 3 , 24 , 25 ].…”

Section: Discussionmentioning

confidence: 64%

“…On MRI, CPPD deposition manifests as a predominately hypointense area on T1 and T2 weighted images, as in the present cases [ 3 , 24 , 25 ]. Moreover, MRI is also useful to assess spinal cord compression or myelopathy [ 3 , 24 , 25 ]. Histology can confirm marked degeneration of elastic fibers about the calcium deposits showing irregular arrangement of the elastic fibers, abnormally small diameter of fragmented elastic fibers, and thick bundles of collagen fibers.…”

Section: Discussionmentioning

confidence: 64%

Cervical myelopathy due to subaxial calcium pyrophosphate dihydrate (CPPD) deposition with simultaneous asymptomatic crowned dens syndrome: two case reports

Chang

Park

Jung

et al. 2020

BMC Musculoskelet Disord

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Background There are few reports of cervical myelopathy caused by an attack of subaxial calcium pyrophosphate dihydrate (CPPD) deposition. Moreover, there has been no report on cervical myelopathy by subaxial CPPD deposition with simultaneous asymptomatic crowned dens syndrome (CDS) at the same time. Case presentation The first case was a 68-year-old male complaining of cervical myelopathic symptoms. Plain radiographs, computed tomography (CT) and magnetic resonance imaging (MRI) findings revealed spinal cord compression by calcified round lesions at C4 as well as a calcified lesion behind the dens. The second case was a 77-year-old female complaining of cervical myelopathic symptoms. Plain radiographs, CT and MRI findings revealed spinal cord compression by calcified round lesions at C3 and C4 as well as a calcified lesion behind the dens. In both cases, we believed that the calcified lesion behind the dens was an asymptomatic lesion. Therefore, the first patient received decompressive laminectomy of C3 and C4, removal of calcified round lesions, and posterior fixation from C3 to C5 due to associated kyphosis. The second patient underwent decompressive laminectomy of C3 and C4 and removal of calcified round lesions. Microscopic examination under polarized light showed dark blue calcifications with rhomboid crystals that were positively birefringent. The findings were consistent with those of CPPD. Conclusions This is the first study to report cervical myelopathy caused by subaxial CPPD deposition with simultaneous asymptomatic CDS. Surgical removal of the subaxial CPPD deposition alone achieved a satisfactory surgical outcome without recurrence.

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“…A study was conducted in the Rheumatology Department of Lariboisiere Hospital in Paris which attempted to find the prevalence of spinal involvement in patients with established diagnoses of widespread CPPD. It was noted that 24% of patients who were hospitalized with CPPD had spinal involvement, mostly affecting the cervical and lumbar spine; however, they had widespread CPPD disease [6]. In this case report, the patient had no previous history of pseudogout and had no other joint involvement after thorough investigation.…”

Section: Discussionmentioning

confidence: 68%

“…Spinal pseudogout is a rare entity, with few case reports described in the literature, most of which depict pseudogout of the cervical region [6]. Based on literature review, the most commonly affected section of the spine has been reported to be the cervical spine [6,7]. A study was conducted in the Rheumatology Department of Lariboisiere Hospital in Paris which attempted to find the prevalence of spinal involvement in patients with established diagnoses of widespread CPPD.…”

Section: Discussionmentioning

confidence: 99%

Trauma Induced Calcium Pyrophosphate Deposition Disease of the Lumbar Spine

Greca

Gabr

Perl

et al. 2020

Case Reports in Rheumatology

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Inflammatory arthritis, such as pseudogout or otherwise referred to as calcium pyrophosphate (CPP) crystal arthritis or calcium pyrophosphate deposition (CPPD) disease, is characterized by the deposition of crystal formation and deposition in large joints. CPPD is known to affect the elderly population and commonly manifests as inflammation of knees, hips, and shoulders. CPPD disease involving the spine has been infrequently encountered in practice and rarely described in the literature. Here, we describe a case of an 80-year-old female with no known history of inflammatory arthritis who presented with left lower extremity weakness and fall, initially thought to have discitis, later confirming CPPD of the spine through biopsy and ultimately resolution of symptoms with anti-inflammatory agents. Although consisting of different clinical presentations, two other case reports have described CPPD of the spine with similar radiographic findings, to this author’s knowledge. With the radiologic similarities, this unique case serves to raise awareness in the medical community and possibly place pseudogout of the spine on the differential list when such cases are encountered. As a result, patients can be initiated on benign anti-inflammatory agents, avoiding invasive testing and unnecessary antibiotic exposure.

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Spinal involvement with calcium pyrophosphate deposition disease in an academic rheumatology center: A series of 37 patients

Cited by 54 publications

References 45 publications

Spinal pseudogout is a joker. Commentary on “Calcium pyrophosphate deposition disease of the cervical and thoracolumbar spine: A report of two cases”

Spinal pseudogout is a joker. Commentary on “Calcium pyrophosphate deposition disease of the cervical and thoracolumbar spine: A report of two cases”

Cervical myelopathy due to subaxial calcium pyrophosphate dihydrate (CPPD) deposition with simultaneous asymptomatic crowned dens syndrome: two case reports

Trauma Induced Calcium Pyrophosphate Deposition Disease of the Lumbar Spine

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