ABSTRACT
CPPD disease can affect patients' quality of life through its various clinical presentations. This mini-review discusses the evolution of CPPD from its discovery to current knowledge of its pathogenesis, genetic associations, diagnostics, and treatment options. Despite extensive research, the exact mechanisms of CPPD are not well understood, and there is a notable lack of knowledge about psychosocial impacts and patient experiences. This study aims to present a CPPD Disease Timeline identifying gaps in current knowledge and potential directions for future research. These findings contribute to a broader understanding of CPPD disease and emphasize the importance of continued research and innovation in this field.
ABSTRACT
The aim of this study was to evaluate the effects of low-level laser therapy using the gallium arsenide laser (λ = 830 nm) on the articular cartilage (AC) organization from knee joint in an experimental model of microcrystalline arthritis in adult male Wistar rats. Seventy-two animals were divided into three groups: A (control), B (induced arthritis), and C (induced arthritis + laser therapy). The arthritis was induced in the right knee using 2 mg of Na4P2O7 in 0.5 mL of saline solution. The treatments were daily applied in the patellar region of the right knee after 48 h of induction. On the 7th, 14th, and 21st days of treatment, the animals were euthanized and their right knees were removed and processed for structural and biochemical analysis of the AC. The chondrocytes positively labeled for the TUNEL reaction were lower in C than in B on the 14th and 21st days. The content of glycosaminoglycans and hydroxyproline in A and C was higher than B on the 21st day. The amount of tibial TNF-α in B and C was lower than in A. The amount of tibial BMP-7 in B and C was higher than in A. The femoral MMP-13 was lower in B and C than for A. The tibial TGF-ß for C was higher than the others. The femoral ADAMT-S4 content of A and C presented similar and inferior data to B on the 21st day. The AsGa-830 nm therapy preserved the content of glycosaminoglycans, reduced the cellular changes and the inflammatory process compared to the untreated group.
Subject(s)
Arthritis, Experimental/radiotherapy , Cartilage, Articular/pathology , Cartilage, Articular/radiation effects , Low-Level Light Therapy , ADAMTS4 Protein/metabolism , Animals , Apoptosis/radiation effects , Arthritis, Experimental/pathology , Bone Morphogenetic Protein 7/metabolism , Cartilage, Articular/ultrastructure , Chondrocytes/pathology , Chondrocytes/radiation effects , Disease Models, Animal , Femur/pathology , Femur/radiation effects , Male , Matrix Metalloproteinase 13/metabolism , Rats, Wistar , Tibia/pathology , Tibia/radiation effects , Tibia/ultrastructure , Transforming Growth Factor beta/metabolismABSTRACT
Resumen En la práctica clínica habitual existe un crecimiento en la demanda asistencial de servicios de urgencias. El dolor cervical es una patología muy frecuente que compete a diversos profesionales sanitarios. El síndrome de apófisis odontoides coronada, es una patología muy poco frecuente, que hace parte del espectro de las enfermedades por microcristales de pirofosfato cálcico, ocasionando una calcificación de ligamentos del proceso de odontoides cervical, llevando a una clínica de cervicalgia, fiebre y rigidez de nuca. Esta patología entra en el diagnóstico diferencial con patologías potencialmente graves. En muchas ocasiones lleva a procedimientos y gastos farmacológicos innecesarios, principalmente por el desconocimiento que la transforma en una patología infradiag-nosticada. (Acta Med Colomb 2018; 43: 230-232).
Abstract In the usual clinical practice there is a growth in the demand for emergency services. Cervical pain is a very common pathology that concerns various health professionals. The crowned den syndrome is a very rare pathology, which is part of the spectrum of microcrystalline diseases of calcium pyrophosphate, causing a calcification of ligaments of the cervical odontoid process, leading to clinical signs of neck pain, fever and neck stiffness. This pathology enters into the differential diagnosis with potentially serious pathologies. In many cases it leads to unnecessary pharmacological procedures and expenses, mainly due to the ignorance that turns it into an infra diagnosed pathology. (Acta Med Colomb 2018; 43: 230-232).
Subject(s)
Humans , Male , Aged , Bone and Bones , Odontoid Process , Syndrome , Chondrocalcinosis , Neck PainABSTRACT
Compressive myelopathy due to calcium pyrophosphate crystals deposit is an uncommon pathology. This disease can be isolated or associated with other articular deposits. We present a 78 year-old women with a story of lower limbs weakness and limitation of motion. Myelopathic signs where found on physical examination, so a cervical spine MRI was performed showing C6-C7 thickening and calcification of yellow ligament with compression of the spinal cord from the back. A surgical procedure with decompressive laminectomy and posterior instrumentation from C5 to C7 was performed The patient evolved favorable without postoperative complications and with neurological recovery from M3 to M4 in lower limbs. Histological study of the yellow ligament showed deposits of calcium pyrophosphate crystals. Calcium pyrophosphate crystals deposit is uncommon in the cervical spine, but it must be considered in the differential diagnosis of posterior cervical cord compression.
La mielopatía cervical por depósito de cristales de pirofosfato de calcio es una patología poco frecuente. Ésta puede presentarse aislada o asociada a otros depósitos articulares. Presentamos el caso clínico de una mujer de 78 años con historia de debilidad de extremidades inferiores y limitación de la marcha. Al ingreso la paciente presentaba signos clínicos de mielopatía. La resonancia nuclear magnética de columna cervical evidenció a nivel C6-C7 engrosamiento y calcificación del ligamento amarillo con compresión del cordón medular de atrás adelante. La paciente fue sometida a una laminectomía descompresiva y fusión posterior instrumentada C5-C7 No hubo complicaciones post operatorias y se observó recuperación neurológica de M3 a M4 en el post operatorio. El estudio anatomopatológico del ligamento amarillo mostró reacción inflamatoria crónica y depósitos de cristales de pirofosfato de calcio. El depósito de cristales de pirofosfato de calcio es poco frecuente en la columna cervical, pero debe considerarse en el diagnóstico diferencial de la mielopatía cervical por compresión medular posterior.