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37 Cards in this Set
- Front
- Back
Where do CPPD crystals frequently deposit?
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Joint cartilage
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What is Chodrocalcinosis?
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-Radiographic evidence of calcified articular cartilage
-NOTE: NOT interchancheable with CPPD |
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Common locations of Chondrocalcinosis
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-Knees
-Wrists/MCPs -Symphysis pubis |
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What is Pyrophosphate arthropathy?
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-Intraarticular deposition of crystals within the cartilage leads to joint manifestations similar to osteoarthiritis
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What is Pseudogout?
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-Clinical presentation of CPPD
-Pt. presents with episodic pain similar to gout -10 - 20% |
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Other than Pseudogout, what are the other presentations of CPPD?
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-Asymptomatic = 10 - 20%
-Pseudo-rheumatic = 2 - 6% -Pseudo-osteoarthritis = 10 - 60% -Pseudo-neuropathy = 0 - 2% -Miscellaneous = 0 - 1% |
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Age and gender common in CPPD?
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-Middle-aged with peak onset around 60 years
-No sex predilection |
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M/C signs/symptoms of CPPD that mimic degeneration?
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-Isidious onset-chronic joint pain
-Decreased ROM -Intermittant swelling and crepitus |
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Prominent places for CPPD?
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-Peripheral joints
-Knees (MC) -Wrist -Hand -Ankles -Hip -Elbows |
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What cases acute synovitis with CPPD?
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-Injecctions of the crystals
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Where are the crystal deposits found in CPPD?
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-Hyaline cartilage
*Within intermediate layer NOT on the surface -Fibrocartilage *Within intermediate layer NOT on the surface -Capsular ligaments and tendons |
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What are the laboratory findings of CPPD?
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-No serum biochemical abnormalities
-Joint aspiration is diagnostic |
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Describe Chondrocalcinosis of hyaline cartilage on film
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-Thin, linear continuous or interrupted separated from but parallels the articular cortex
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Describe chondrocalcinosis of fibrocartilage on film
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-Thick, irregular, may have a shaggy appearance and poorly defined margins
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Describe chondrocalcinosis of joint capsules
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-Tends to appear linear and bridge the joint
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Describe chondrocalcinosis of synovium
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-Poorly defined
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MC locations of Chondrocalcinosis
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-Menisci of the knees
-Triangular fibrocartilage -Lunotriquetral ligament -Symphysis pubis -Labrums |
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Diseases CPPD is associated with
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-"WHIP A DOG"
-Wilsons disease -Hyperparathyroidism/Hemochromatosis -Idiopathic -Pseudogout - MC -Acromegaly -Diabetes Mellitus -Ochronosis -Gout |
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2 forms of hemochromatosis (excessive cellular uptake of iron)
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-Primary form
*autosomal recessive *Bronze diabetes -Secondary form *Multiple blood transfusions |
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How is hemochromatosis similar to CPPD radiographically?
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-Predilection for the 2nd & 3rd MCp
-Beaklike osteophytes at the radial margins -MRI is the best imaging exam demonstrating iron deposits within the liver |
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Signs of CPPD in the knee (MC)
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-Chondrocalcinosis
-Unusual compartment distribution -Subchondral cysts and sclerosis |
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Signs of CPPD in the wrist
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-Chondrocalcinosis of the fibrocartilage of the ulnocarpal joint is common
-Arthropathy favots the radiocarpal joint -May lead to a SLAC wrist -"Spotty Carpal" sign *RA *Gout *CPPD *Sudeck's atrophy |
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Where is CPPD in the spine seen?
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-Mostly in the lumbar spine
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Where does CPPD affect the shoulder?
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-Glenohumeral joint
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Where does CPPD affect the hip?
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-Hyaline cartilage of the femoral head
-Acetabular labrum -May produce a protrusio acetabuli |
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What kind of calcification is seen in the symphysis pubis with CPPD?
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-Vertical calcification
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What is the AKA for Hydroxyapatite Deposition Disease (HADD)?
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-Calcific tendonitis
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Age and gender with HADD?
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-Age onset is normally 40 - 70 years
-No sex predilection |
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Symptoms of HADD
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-Characteristically monoarticular
-Frequently asymptomatic -Pain, tenderness, local swelling -May mimic a monoarticular arthritis or setic arthritis |
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What is seen in the films in periarticular locations of a patient with HADD?
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-Homogenous cloudlike calcification
*Tendons *Legaments *Joint capsules *Bursae |
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MC locations of HADD?
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-(Descending order)
-Shoulder -Hips -Spine -Fingers -Elbow -Wrist -Knee -Ankle |
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What are the sites of involvement in descending order of HADD in the shoulder (MC)?
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-Supraspinatus
-Infraspinatus -Teres Minor -Subscapularis -Biceps tendon (both heads) -Subacromial/subdeltoid bursa |
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What view is HADD best seen in supraspinatus?
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-External rotation
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What view is HADD best seen in infraspinatus?
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-Internal rotation
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Where is HADD commonly seen in the hip?
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-Commonly affects the gluteus maximus near the insertion on the femur
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What are the 2 sites of involvement of HADD in the spine?
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-Longus Coli muscle
*Usually located anterior to C2 and inferior to the anterior tubercle of C1 -Intervertebral Disc *causes for disc calcifications ^degeneration ^congenital block ^idiopathic |
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Where is HADD commonly seen in the knee?
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-Medial collateral ligament (MCL)
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