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CALCIUM PYROPHOSPHATE DIHYDRATE (CPPD) CRYSTAL DEPOSITION DISEASE

Hancock HMH - MedPix (2006)

View Article: MedPix Image - MedPix Case

Affiliation: Uniformed Services University

ABSTRACT

Diagnosis: CALCIUM PYROPHOSPHATE DIHYDRATE (CPPD) CRYSTAL DEPOSITION DISEASE

History: CC/HPI: 72 y/o female presents with history of several weeks bilateral persistent knee pain who now complains of an increase in right knee pain of abrupt onset over past few days. The pain is minimally relieved with percocet, and self-rated as 9/10. The patient denied any precipitating trauma, constitutional symptoms of fatigue/fever/weight change, and claims no arthralgias/myalgias/neuropathic pain. Patient has swelling and warmth associated with the joint pain. Social history is significant for a positive current smoking profile and no ETOH use.

Findings: Chondrocalcinosis of the menisci of both knees with severe patellofemoral joint space narrowing bilaterally. Medial and lateral intraarticular joint spaces are preserved bilaterally, as demonstrated on the AP radiograph. A suprapatellar effusion of the right knee is present. No left knee effusion is seen.

Ddx: Diseases associated with CPPD Gout Hyperparathyroidism Hemochromatosis Hypophosphatasia Hypothyroidism Neuropathic osteoarthropathy Amyloidosis Long-term corticosteroid therapy

Dxhow: Characteristic radiographic findings

Exam: Physical examination: Patient has pain with ambulation. Knees no pain to palpation, no nodules, no muscle weakness, no warmth to touch, no erythema. (Lt knee): full ROM. (Rt knee):some generalized swelling, + pain with extension, decreased ROM secondary to pain Pertinent laboratory studies showed ESR 65 (H), ANA (-), Rheumatoid factor 10.8 (0-14), Urate 4.3, C-reactive protein 0.219, Glucose 107, K 5.1, Na 136, GFR nml, TSH nml, all remaining labs within normal limits

No MeSH data available.


Anteroposterior radiograph of the right knee linear calcifications in the meniscis consistent with chondrocalcinosis and osteophytes particularly in the medial joint compartment
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MPX1215_synpic31051: Anteroposterior radiograph of the right knee linear calcifications in the meniscis consistent with chondrocalcinosis and osteophytes particularly in the medial joint compartment


CALCIUM PYROPHOSPHATE DIHYDRATE (CPPD) CRYSTAL DEPOSITION DISEASE

Hancock HMH - MedPix (2006)

Anteroposterior radiograph of the right knee linear calcifications in the meniscis consistent with chondrocalcinosis and osteophytes particularly in the medial joint compartment
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=MPX1215&req=5

MPX1215_synpic31051: Anteroposterior radiograph of the right knee linear calcifications in the meniscis consistent with chondrocalcinosis and osteophytes particularly in the medial joint compartment

View Article: MedPix Image - MedPix Case

Affiliation: Uniformed Services University

ABSTRACT

Diagnosis: CALCIUM PYROPHOSPHATE DIHYDRATE (CPPD) CRYSTAL DEPOSITION DISEASE

History: CC/HPI: 72 y/o female presents with history of several weeks bilateral persistent knee pain who now complains of an increase in right knee pain of abrupt onset over past few days. The pain is minimally relieved with percocet, and self-rated as 9/10. The patient denied any precipitating trauma, constitutional symptoms of fatigue/fever/weight change, and claims no arthralgias/myalgias/neuropathic pain. Patient has swelling and warmth associated with the joint pain. Social history is significant for a positive current smoking profile and no ETOH use.

Findings: Chondrocalcinosis of the menisci of both knees with severe patellofemoral joint space narrowing bilaterally. Medial and lateral intraarticular joint spaces are preserved bilaterally, as demonstrated on the AP radiograph. A suprapatellar effusion of the right knee is present. No left knee effusion is seen.

Ddx: Diseases associated with CPPD Gout Hyperparathyroidism Hemochromatosis Hypophosphatasia Hypothyroidism Neuropathic osteoarthropathy Amyloidosis Long-term corticosteroid therapy

Dxhow: Characteristic radiographic findings

Exam: Physical examination: Patient has pain with ambulation. Knees no pain to palpation, no nodules, no muscle weakness, no warmth to touch, no erythema. (Lt knee): full ROM. (Rt knee):some generalized swelling, + pain with extension, decreased ROM secondary to pain Pertinent laboratory studies showed ESR 65 (H), ANA (-), Rheumatoid factor 10.8 (0-14), Urate 4.3, C-reactive protein 0.219, Glucose 107, K 5.1, Na 136, GFR nml, TSH nml, all remaining labs within normal limits

No MeSH data available.