Chondrocalcinosis: Difference between revisions

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#redirect [[Crystals in body fluids#Pseudogout]]
{{ Infobox diagnosis
| Name      = {{PAGENAME}}
| Image      = Pseudogout_-_very_high_mag.jpg
| Width      =
| Caption    = Chondrocalcinosis. [[H&E stain]].
| Synonyms  = calcium pyrophosphate dihydrate deposition disease, calcium pyrophosphate deposition, pseudogout (old term)
| Micro      = crystals with a rhomboid-shape; polarized light: positively birefringent, blue when aligned
| Subtypes  =
| LMDDx      = benign calcifications, [[osteoarthritis]]
| Stains    =
| IHC        =
| EM        =
| Molecular  =
| IF        =
| Gross      = +/-subchondral cysts, degeneration of cartilage
| Grossing  =
| Site      = [[joints]] - especially knee
| Assdx      =
| Syndromes  =
| Clinicalhx =
| Signs      =
| Symptoms  = joint pain
| Prevalence = uncommon
| Bloodwork  =
| Rads      = +/-[[loose bodies]], joint space narrowing, narrowing of patellofemoral joint
| Endoscopy  =
| Prognosis  = benign
| Other      =
| ClinDDx    = [[osteoarthritis]], other types of [[arthritis]]
| Tx        =
}}
'''Chondrocalcinosis''', also '''calcium pyrophosphate deposition''' and '''calcium pyrophosphate dihydrate deposition disease''' (abbreviated '''CPPD'''),<ref>URL: [http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001458/ http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001458/]. Accessed on: 28 October 2011.</ref> is a benign condition of the [[joints]].
 
It was previously known as '''pseudogout'''.<ref>URL: [http://www.rheumatology.org/practice/clinical/patients/diseases_and_conditions/pseudogout.asp http://www.rheumatology.org/practice/clinical/patients/diseases_and_conditions/pseudogout.asp]. Accessed on: 12 March 2014.</ref>
 
==General==
*Classically found in the knee.
*Associated with low bone mineral density and vascular calcification.<ref name=pmid23912799>{{Cite journal  | last1 = Abhishek | first1 = A. | last2 = Doherty | first2 = S. | last3 = Maciewicz | first3 = R. | last4 = Muir | first4 = K. | last5 = Zhang | first5 = W. | last6 = Doherty | first6 = M. | title = Association between low cortical bone mineral density, soft-tissue calcification, vascular calcification and chondrocalcinosis: a case-control study. | journal = Ann Rheum Dis | volume =  | issue =  | pages =  | month = Aug | year = 2013 | doi = 10.1136/annrheumdis-2013-203400 | PMID = 23912799 }}</ref>
 
==Gross==
*Degeneration of cartilage.
*Subchondral sclerosis.
 
===Radiology===
*Similar to [[osteoarthritis]] - joint space narrowing & subchondral sclerosis.<ref name=learningrads>URL: [http://www.learningradiology.com/archives04/COW%20102-CPPD/cppdcorrectpage.htm http://www.learningradiology.com/archives04/COW%20102-CPPD/cppdcorrectpage.htm]. Accessed on: 9 October 2013.</ref>
 
Findings suggestive of CPPD:<ref name=learningrads>URL: [http://www.learningradiology.com/archives04/COW%20102-CPPD/cppdcorrectpage.htm http://www.learningradiology.com/archives04/COW%20102-CPPD/cppdcorrectpage.htm]. Accessed on: 9 October 2013.</ref>
*Subchondral cysts (large) - important.
*Intra-articular bodies, several.
*Increased narrowing of patellofemoral joint.
 
==Microscopic==
Features:
*Crystals with a rhomboid-shape.
**Positively birefringent, blue when aligned.
 
Notes:
*Memory device: ''ABC+'' = ''a''ligned ''b''lue is ''c''alcium & ''c''uboid - positively birefringent.
 
===Images===
<gallery>
Image: Pseudogout - low mag.jpg | Pseudogout - low mag. (WC)
Image:Pseudogout_-_intermed_mag.jpg | Pseudogout - intermed. mag. (WC)
Image:Pseudogout_-_high_mag.jpg | Pseudogout - high mag. (WC)
Image:Pseudogout_-_very_high_mag.jpg | Pseudogout - very high mag. (WC)
</gallery>
www:
*[http://ard.highwire.org/content/58/5/261/F2.large.jpg Pseudogout (highwire.org)].<ref name=pmid10225806>{{Cite journal  | last1 = Dieppe | first1 = P. | last2 = Swan | first2 = A. | title = Identification of crystals in synovial fluid. | journal = Ann Rheum Dis | volume = 58 | issue = 5 | pages = 261-3 | month = May | year = 1999 | doi =  | PMID = 10225806 | PMC = 1752883 | URL = http://ard.highwire.org/content/58/5/261.full }}</ref>
 
==Sign-out==
<pre>
KNEE - BONE AND SOFT TISSUE, RIGHT, KNEE ARTHROPLASTY:
- DEGENERATIVE JOINT DISEASE WITH SYNOVIAL HYPERPLASIA AND
  NO SIGNIFICANT INFLAMMATION.
- CRYSTALLINE DEPOSITS CONSISTENT WITH PSEUDOGOUT.
- BONE WITH THIN TRABECULAE.
</pre>
<pre>
BONE, LEFT KNEE, JOINT REPLACEMENT:
- DEGENERATIVE JOINT DISEASE.
- CRYSTALS CONSISTENT WITH PSEUDOGOUT.
- SYNOVIAL HYPERPLASIA WITH RARE GIANT CELLS.
- NEGATIVE FOR MALIGNANCY.
</pre>
<pre>
FEMORAL HEAD AND JOINT CAPSULE, LEFT, HIP ARTHROPLASTY:
- DEGENERATIVE JOINT DISEASE WITH MILD LYMPHOPLASMACYTIC INFLAMMATION.
- CRYSTALLINE DEPOSITS CONSISTENT WITH CHONDROCALCINOSIS.
- NEGATIVE FOR MALIGNANCY.
</pre>
===Micro===
The soft tissue section shows readily apparent rhomboid-shaped crystalline deposits
(compatible with pseudogout). The crystals polarize and have a light blue hue under
polarized light. Synovial hyperplasia is present. No lymphoid aggregates are apparent.
 
The bony section show thin bony trabeculae and cartilage with
degenerative changes (surface fibrillation, thinning).
 
==See also==
*[[Joints]].
*[[Crystals in body fluids]].
 
==References==
{{Reflist|2}}
 
[[Category:Crystals in body fluids]]
[[Category:Diagnosis]]
Retrieved from "https://librepathology.org/wiki/Chondrocalcinosis"