Clinical characteristics and medical imaging analysis of 20 cases with calcium pyrophosphate deposition / 中华风湿病学杂志

ABSTRACT

Objective To investigate the clinical and imaging features of patients with calcium pyrophosphate deposition (CPPD).Methods The clinical data and X-rays material of knee joint of 20 patients with CPPD were retrospectively analyzed.Pearson/Spearman's correlations analysis was used for statistical analysis with software version 15.0.Results The 20 patients with CPPD had demonstrated that the typical accumulation of calcium,which accounted for about 1.5％o(20/13 536) among patients over 55 years old who had knees X-ray at the same period in Chaoyang Hospital.Female patients of CPPD was 80％ (16/20).Seventeen patients completed follow-up visits.The age of onset for CPPD ranged from 44 to 85 years old,the percentage of CPPD patients over 70 years old was 71％(12/17).Among the 17 cases of followed,14 cases (82％) were patients with paroxysmal arthritis with the initial site of knee joint (79％) and ankle joint (21％).Most patients suffered from moderate to severe pain,while some might have local congestion and increased skin temperature.Five patients had more than two different joints attacked by arthritis.The distribution of the affected areas was knee,ankle,hip,elbow,wrist and metacarpophalangeal joints.The median number of attack was 1.5 times a year,and the median duration of attack was 8.5 days.Among the 14 patients,Six cases of them had no recurrence after treatment,but six cases had recurrent attacks within a year.The imaging of lateral articular facet showed that calcium deposit was extended and thickness of calcification was increased.Plus osteophyte formation stage was 100％ with an average of 3.0±1.6 and 85％ sclerosis of articular facet.The rate of attacks of arthritis had a positive correlation with calcium deposition range of lateral articular facet (r=0.663,P=0.010) and a negative correlation with sclerosis of articular facet (r=-0.548,P=0.042).Conclusion Old patients with paroxysmal joint pain,patients with knee joint or other big joints as the initial joints involved,patients with long duration disease,patients who had more than two joints at attack and patients with calcium deposition in imaging,should be suspected for CPPD clinically.Moreover,patients with a wide range of calcium deposition are high likely to suffer from recurrent arthritis attack.