Chondrocalcinosis

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Chondrocalcinosis
X-ray of a knee with chondrocalcinosis
SpecialtyRadiology

Chondrocalcinosis or cartilage calcification is calcification (accumulation of calcium salts) in hyaline cartilage and/or fibrocartilage.[1] Chondrocalcinosis is an observation that can be visualized through diagnostic imaging tests such as X-rays, CT, MRI, and ultrasound.[2]

Causes[edit]

Buildup of calcium phosphate in the ankle joints has been found in about 50% of the general population, and may be associated with osteoarthritis.[3]

Another common cause of chondrocalcinosis is calcium pyrophosphate dihydrate crystal deposition disease (CPPD).[4] CPPD is estimated to affect 4–7% of the adult populations of Europe and the United States.[5] Chondrocalcinosis can be seen in approximately 40% of those with CPPD.[6] Previous studies have overestimated the prevalence by simply estimating the prevalence of chondrocalcinosis regardless of cause.[5]

A magnesium deficiency may cause chondrocalcinosis, and there is anecdotal evidence that magnesium supplementation may reduce or alleviate symptoms.[7] In some cases, arthritis from injury can cause chondrocalcinosis.[8] Other causes of chondrocalcinosis include:[4]

Symptoms

Chondrocalcinosis does not always lead to symptoms. However, chondrocalcinosis in the presence of CPPD may cause symptoms similar to Pseudogout, Pseudo-rheumatoid arthritis, and Pseudo-osteoarthritis. Chondrocalcinosis may be accompanied by joint pain, joint swelling, and decreased range of motion.[9]

Chondrocalcinosis sites

Chondrocalcinosis affects common areas such as the knee, wrist, hand, and pelvis.[10] Chondrocalcinosis can also be visualized affecting the spine. "Crowned Dens Syndrome" is an example of chondrocalcinosis affecting cervical vertebrae.[11]

Diagnosis[edit]

Chondrocalcinosis can be visualized on projectional radiography, CT scan, MRI, ultrasound, and nuclear medicine.[1] CT scans and MRIs show calcific masses (usually within the ligamentum flavum or joint capsule), however radiography is more successful.[1] At ultrasound, chondrocalcinosis may be depicted as echogenic foci with no acoustic shadow within the hyaline cartilage.[12] As with most conditions, chondrocalcinosis can present with similarity to other diseases such as ankylosing spondylitis and gout.[1]

Genetics

More research is needed on the role of genetics in the development of chondrocalcinosis and CPPD, but there is some evidence that mutations of the ANKH gene may lead to chondrocalcinosis.[13]

References[edit]

  1. ^ a b c d Rothschild BM, Bruno MA (9 April 2021). Coombs BD, Keats TE, Chew FS (eds.). "Calcium Pyrophosphate Deposition Disease".
  2. ^ Miksanek J, Rosenthal AK (March 2015). "Imaging of calcium pyrophosphate deposition disease". Current Rheumatology Reports. 17 (3): 20. doi:10.1007/s11926-015-0496-1. PMC 5471493. PMID 25761927.
  3. ^ Hubert J, Weiser L, Hischke S, Uhlig A, Rolvien T, Schmidt T, et al. (May 2018). "Cartilage calcification of the ankle joint is associated with osteoarthritis in the general population". BMC Musculoskeletal Disorders. 19 (1): 169. doi:10.1186/s12891-018-2094-7. PMC 5968601. PMID 29793463.
  4. ^ a b Morgan MA, Gaillard F, et al. "Chondrocalcinosis". Radiopedia. Retrieved 2017-08-11.
  5. ^ a b Rosenthal AK. "Clinical manifestations and diagnosis of calcium pyrophosphate crystal deposition (CPPD) disease". UpToDate. This topic last updated: Jul 24, 2018.
  6. ^ Rosenthal, Ann K.; Ryan, Lawrence M. (2016-06-30). Campion, Edward W. (ed.). "Calcium Pyrophosphate Deposition Disease". New England Journal of Medicine. 374 (26): 2575–2584. doi:10.1056/NEJMra1511117. ISSN 0028-4793. PMC 6240444. PMID 27355536.
  7. ^ de Filippi JP, Diderich PP, Wouters JM (January 1992). "[Hypomagnesemia and chondrocalcinosis]". Nederlands Tijdschrift voor Geneeskunde. 136 (3): 139–141. PMID 1732847.
  8. ^ Wright GD, Doherty M (October 1997). "Calcium pyrophosphate crystal deposition is not always 'wear and tear' or aging". Annals of the Rheumatic Diseases. 56 (10): 586–588. doi:10.1136/ard.56.10.586. PMC 1752269. PMID 9389218.
  9. ^ Ivory, Dedri; Velázquez, Celso R. (2012). "The forgotten crystal arthritis: calcium pyrophosphate deposition". Missouri Medicine. 109 (1): 64–68. ISSN 0026-6620. PMC 6181683. PMID 22428450.
  10. ^ Miksanek, Jennifer; Rosenthal, Ann K. (March 2015). "Imaging of calcium pyrophosphate deposition disease". Current Rheumatology Reports. 17 (3): 20. doi:10.1007/s11926-015-0496-1. ISSN 1534-6307. PMC 5471493. PMID 25761927.
  11. ^ Saylısoy, Suzan (2020). "A case of acute calcium pyrophosphate arthritis in two rare sites of involvement: The cervical facet and atlantoaxial joint". Joint Diseases and Related Surgery. 31 (2): 395–398. doi:10.5606/ehc.2020.74329. ISSN 2687-4792. PMC 7489169. PMID 32584744.
  12. ^ Arend CF (2013). "Acromioclavicular chondrocalcinosis". Ultrasound of the Shoulder. Master Medical Books. ShoulderUS.com. Archived from the original on 4 March 2016.
  13. ^ Pendleton, Adrian; Johnson, Michelle D.; Hughes, Anne; Gurley, Kyle A.; Ho, Andrew M.; Doherty, Michael; Dixey, Josh; Gillet, Pierre; Loeuille, Damien; McGrath, Rodney; Reginato, Antonio; Shiang, Rita; Wright, Gary; Netter, Patrick; Williams, Charlene (October 2002). "Mutations in ANKH Cause Chondrocalcinosis". The American Journal of Human Genetics. 71 (4): 933–940. doi:10.1086/343054. ISSN 0002-9297. PMC 378546. PMID 12297987.
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