Ultrasonographic diagnosis of articular chondrocalcinosis.

To investigate the role of high-frequency ultrasonography in the diagnosis of calcium pyrophosphate dihydrate (CPPD) calcifications, in the most commonly affected joints in CPPD disease. Sixty patients with knee effusion were included in the study. All patients underwent musculoskeletal ultrasonography (on the shoulder, elbow, wrist, and knee joints), radiological examination of the sites examined by US, and synovial fluid analysis (using polarized light microscopy). Out of 60 patients with knee effusion, ultrasonographic calcifications (knees, shoulders, and wrists) were present in 38 patients (63.3%) and out of those patients; 32 had calcification characteristic of CPPD crystals deposition (hyperechoic deposits) in the knee and wrist joints. Pattern II (punctate pattern) was the most common pattern of calcification. It was present in all patients who had wrist calcification (18 patients) and in the knee in either alone (21 patients) or in association with pattern I (hyperechoic band) and/or pattern III (hyperechoic nodular or oval deposits) (9 patients). The sensitivity of ultrasonography for the detection of calcification was 84.2% while that of plain radiography was 13.2%, the specificity of both ultrasonography and plain radiography for the detection of calcification was 100%, and ultrasonography is valuable for diagnosing articular chondrocalcinosis via the detection of calcifications within the joint cartilage and fibrocartilage. Both sensitivity and specificity are high for detecting CPPD deposits.

Ultrasonographic findings of Achilles tendon and plantar fascia in patients with calcium pyrophosphate deposition disease.

The aims of the study were to detect the frequency of involvement of the Achilles tendon and plantar fascia in patients with calcium pyrophosphate deposition disease (CPPD) by high-frequency gray-scale ultrasonography (US) and power Doppler sonography (PDS) and to correlate these findings with demographic and clinical data. Two groups of patients were enrolled: group I (38 patients with CPPD) and group II (22 patients with knee OA). US/PDS examination of the heels was performed to both groups. In the CPPD group, US/PDS examination of the Achilles tendon revealed: calcification in 57.9%, enthesophytosis in 57.9%, enthesopathy in 23.7%, vascular sign in 21%, bursitis in 13.2%, and cortical bone irregularity in 10.5%. US/PDS examination of plantar fascia in the CPPD group revealed: calcification in 15.8%, cortical bone irregularity in 78.9%, enthesophytosis in 60.5%, and planter fasciitis in 42.1%. In patients with CPPD, age was significantly correlated with enthesophytosis and deep retrocalcaneal bursitis (p = 0.01 and p = 0.04, respectively). Heel tenderness and posterior talalgia were significantly correlated with Achilles tendon enthesopathy, vascular sign, and deep retrocalcaneal bursitis (p = 0.0001 for each). Inferior talalgia was significantly correlated with plantar fasciitis (p = 0.0001). The sensitivity of ultrasonography for detection of calcifications in Achilles tendon and plantar fascia was 57.9% and 15.8%, respectively, and the specificity was 100% for both. To conclude, ultrasonographic Achilles tendon and plantar fascia calcifications are frequent findings in patients with CPPD. These calcifications have a high specificity and can be used as a useful indirect sign of CPPD.