Calcification in calcium pyrophosphate dihydrate (CPPD) crystalline deposits in the knee: anatomic, radiographic, MR imaging, and histologic study in cadavers.

OBJECTIVE: To demonstrate and determine the frequency and location of calcification within cadaveric knees with or without calcification typical of calcium pyrophosphate dihydrate (CPPD), utilizing histologic, radiographic and MR imaging techniques. DESIGN AND PATIENTS: Ten cadaveric knees of elderly individuals that demonstrated no radiographic evidence of prior surgery or trauma were studied with MR imaging and subsequently sectioned in planes corresponding to those obtained with MR imaging. The slices were imaged with high-resolution radiography. Two musculoskeletal radiologists correlated the anatomic, MR and radiographic findings. Three of the knees, which did not demonstrate calcifications, were utilized as controls. Histologic sections were obtained from four knees that contained calcifications and from the three controls, and analyzed with special histologic stains that demonstrate phosphorus and calcium. RESULTS: Radiographic imaging and histologic analysis demonstrated widespread CPPD crystal deposition in four of the 10 knee specimens (40%). MR imaging demonstrated some calcifications only within the articular cartilage of the femoral condyles in three of the four (75%) specimens that had CPPD deposits. In all four specimens radiographs and histologic analysis were more sensitive than MR imaging. Histologic analysis demonstrated no evidence of CPPD crystals in the control specimens. CONCLUSION: MR imaging is insensitive to the presence of CPPD deposits in the knee, even when such deposits are widespread. Our study suggests that the sensitivity of MR imaging was significantly better in detecting CPPD deposits in the hyaline cartilage of the femoral condyles when compared with other internal structures, even when such structures contained a higher amount of calcification.

Coffee Leaf Scorch Bacterium: Axenic Culture, Pathogenicity, and Comparison with Xylella fastidiosa of Citrus.

Symptoms of coffee leaf scorch (CLS) appear on young flushes of field plants as large marginal and apical scorched areas on recently mature leaves. Affected leaves drop, shoot growth is stunted, and apical leaves are small and chlorotic. Symptoms may progress to shoot dieback. Only scorched leaves which could not be related to other known agents consistently contained bacteria and bacterial agglomerates when observed with light microscopy. Only plants with these symptoms were positive in enzyme-linked immunosorbent assay (ELISA) tests using antiserum to Xylella fastidiosa Wells et al. The bacterium Xylella fastidiosa Wells et al. was isolated in November 1995 from coffee (Coffea arabica) leaves with scorch symptoms on supplemented periwinkle wilt medium. Colonies were circular, dome-shaped, white, and 0.5 to 1.5 mm in diameter. Two of 10 young coffee seedlings stem-inoculated with a suspension of the isolated X. fastidiosa in January 1996 showed leaf scorch symptoms 3 to 5 months later, contained bacteria in xylem extracts, and reacted positively in ELISA using antiserum to the citrus variegated chlorosis (CVC) strain of X. fastidiosa. ELISA-positive bacteria were reisolated from this plant. None of the symptomless plants, including controls, revealed bacteria on microscopic examinations, ELISA, or isolation attempts. Antisera developed against cultured bacteria from both CLS and CVC plants reacted positively against plant extracts of both diseases in dot immunobinding assays (DIBA). The level of detection was about 5 × 105 bacteria ml-1 for both homologous and heterologous reactions. The polymerase chain reaction amplification products produced by CLS and CVC strains of X. fastidiosa were indistinguishable. Geographical distribution of these strains is not the same. CLS is widespread and usually occurs if coffee is adjacent to CVC-affected citrus. However, CVC does not always occur when citrus is grown adjacent to CLS-affected coffee. The bacteria are closely related, if not identical.