RESUMO
We report a case of calcium pyrophosphate deposition disease (CPPD) with an unusual presentation of severe chondrocalcinosis with atypical large burden deposited in the metacarpophalangeal joints as well as more typical deposition in wrists and knees as demonstrated on plain radiographs. A 77-year-old African-American woman 1-year status post parathyroidectomy for hyperparathyroidism initially presented to the rheumatology clinic to treat suspected rheumatoid arthritis given her pattern of joint involvement but was found to have CPPD. The patient's history is notable for end-stage renal disease which complicates medical management. This case illustrates radiographic findings of CPPD and explores the challenges of treating CPPD in the setting of comorbid conditions.
Assuntos
Artralgia/etiologia , Pirofosfato de Cálcio/metabolismo , Condrocalcinose/complicações , Articulação Metacarpofalângica , Idoso , Articulação do Tornozelo/diagnóstico por imagem , Anti-Inflamatórios/uso terapêutico , Condrocalcinose/diagnóstico , Condrocalcinose/tratamento farmacológico , Condrocalcinose/metabolismo , Diagnóstico Diferencial , Feminino , Humanos , Articulação do Joelho/diagnóstico por imagem , Articulação Metacarpofalângica/diagnóstico por imagem , Prednisona/uso terapêuticoRESUMO
Histoplasmosis is an important cause of morbidity in endemic areas of the USA. Infection is often asymptomatic but can cause a broad spectrum of pathology. Less commonly, histoplasmosis can present with a wide-range of rheumatologic manifestations. The aim of this review is to provide a synopsis of the rheumatologic manifestations of this endemic mycosis in addition to emphasizing the high degree of histoplasmosis infection in persons with rheumatologic disease.
