Click on Images for Enlarged View

Findings: Medial joint space narrowing, subchondral sclerosis, osteophyte formation, chondrocalinosis.

Diagnosis: Calcium pyrophosphate dihydrate (CPPD) arthropathy.

Discussion: Chondrocalcinosis is the calcification of a hyaline (articular) cartilage or fibrocartilage (menisci). It most commonly is seen in CPPD; however, it can also occur in other diseases including hemochromatosis and hyperparathyroidism.

CPPD crystal deposition disease most commonly affects patients who are middle-aged or older. It affects men and women equally. CPPD arthropathy involves structural damage to articular cartilage secondary to CPPD crystal deposition in joints. Pseudogout syndrome refers to acute pain similar to that seen in gouty arthritis without response to the usual treatment for gout.

The radiographic findings of CPPD arthropathy are similar to those seen in osteoarthritis: joint space narrowing, subchondral sclerosis, and osteophytosis; however, the wrist, elbow, shoulder, ankle, and femoropatellar joint are also characteristically involved in CPPD arthropathy. Also, chondrocalcinosis is seen, and the tendons, ligaments, and joint capsule may calcify as well.

References:
Resnick & Niwayama. Diagnosis of Bone and Joint Disorders.
1723, 1656, 1768, 2245, 1998.

Greenspan. Orthopedic Radiology. 14.10, 1992.

Return to Musculoskeletal Teaching File Page