Chondrocalcinosis

Buildup of calcium phosphate in the ankle joints has been found in about 50% of the general population, and may be associated with osteoarthritis.{{cite journal | vauthors = Hubert J, Weiser L, Hischke S, Uhlig A, Rolvien T, Schmidt T, Butscheidt SK, Püschel K, Lehmann W, Beil FT, Hawellek T | display-authors = 6 | title = Cartilage calcification of the ankle joint is associated with osteoarthritis in the general population | journal = BMC Musculoskeletal Disorders | volume = 19 | issue = 1 | pages = 169 | date = May 2018 | pmid = 29793463 | pmc = 5968601 | doi = 10.1186/s12891-018-2094-7 | doi-access = free }}

Another common cause of chondrocalcinosis is calcium pyrophosphate dihydrate crystal deposition disease (CPPD).{{cite web|url=https://radiopaedia.org/articles/chondrocalcinosis|title=Chondrocalcinosis|website=Radiopedia | vauthors = Morgan MA, Gaillard F, etal |access-date=2017-08-11}} CPPD is estimated to affect 4–7% of the adult populations of Europe and the United States.{{cite web|url=https://www.uptodate.com/contents/clinical-manifestations-and-diagnosis-of-calcium-pyrophosphate-crystal-deposition-cppd-disease|title=Clinical manifestations and diagnosis of calcium pyrophosphate crystal deposition (CPPD) disease| vauthors = Rosenthal AK |website=UpToDate}} This topic last updated: Jul 24, 2018. Chondrocalcinosis can be seen in approximately 40% of those with CPPD.{{Cite journal |last1=Rosenthal |first1=Ann K. |last2=Ryan |first2=Lawrence M. |date=2016-06-30 |editor-last=Campion |editor-first=Edward W. |title=Calcium Pyrophosphate Deposition Disease |journal=New England Journal of Medicine |volume=374 |issue=26 |pages=2575–2584 |doi=10.1056/NEJMra1511117 |issn=0028-4793 |pmc=6240444 |pmid=27355536}} Previous studies have overestimated the prevalence by simply estimating the prevalence of chondrocalcinosis regardless of cause.

A magnesium deficiency may cause chondrocalcinosis, and there is anecdotal evidence that magnesium supplementation may reduce or alleviate symptoms.{{cite journal | vauthors = de Filippi JP, Diderich PP, Wouters JM | title = [Hypomagnesemia and chondrocalcinosis] | journal = Nederlands Tijdschrift voor Geneeskunde | volume = 136 | issue = 3 | pages = 139–141 | date = January 1992 | pmid = 1732847 }} In some cases, arthritis from injury can cause chondrocalcinosis.{{cite journal | vauthors = Wright GD, Doherty M | title = Calcium pyrophosphate crystal deposition is not always 'wear and tear' or aging | journal = Annals of the Rheumatic Diseases | volume = 56 | issue = 10 | pages = 586–588 | date = October 1997 | pmid = 9389218 | pmc = 1752269 | doi = 10.1136/ard.56.10.586 }}

Other causes of chondrocalcinosis include:

• Hypercalcaemia, especially when caused by hyperparathyroidism
• Arthritis
• Pseudogout
• Wilson disease
• Hemochromatosis
• Ochronosis
• Hypophosphatasia
• Hypothyroidism
• Hyperoxalemia
• Acromegaly
• Gitelman syndrome

{{Heading|Symptoms}}

Chondrocalcinosis does not always lead to symptoms. However, chondrocalcinosis in the presence of CPPD may cause symptoms similar to Pseudogout, Pseudo-rheumatoid arthritis, and Pseudo-osteoarthritis. Chondrocalcinosis may be accompanied by joint pain, joint swelling, and decreased range of motion.{{Cite journal |last=Ivory |first=Dedri |last2=Velázquez |first2=Celso R. |date=2012 |title=The forgotten crystal arthritis: calcium pyrophosphate deposition |url=https://pubmed.ncbi.nlm.nih.gov/22428450 |journal=Missouri Medicine |volume=109 |issue=1 |pages=64–68 |issn=0026-6620 |pmc=6181683 |pmid=22428450}}

{{Heading|Chondrocalcinosis sites}}

Chondrocalcinosis affects common areas such as the knee, wrist, hand, and pelvis.{{Cite journal |last=Miksanek |first=Jennifer |last2=Rosenthal |first2=Ann K. |date=March 2015 |title=Imaging of calcium pyrophosphate deposition disease |url=https://pubmed.ncbi.nlm.nih.gov/25761927 |journal=Current Rheumatology Reports |volume=17 |issue=3 |pages=20 |doi=10.1007/s11926-015-0496-1 |issn=1534-6307 |pmc=5471493 |pmid=25761927}} Chondrocalcinosis can also be visualized affecting the spine. "[https://radiopaedia.org/articles/crowned-dens-syndrome?lang=us Crowned Dens Syndrome]" is an example of chondrocalcinosis affecting cervical vertebrae.{{Cite journal |last=Saylısoy |first=Suzan |date=2020 |title=A case of acute calcium pyrophosphate arthritis in two rare sites of involvement: The cervical facet and atlantoaxial joint |url=https://pubmed.ncbi.nlm.nih.gov/32584744 |journal=Joint Diseases and Related Surgery |volume=31 |issue=2 |pages=395–398 |doi=10.5606/ehc.2020.74329 |issn=2687-4792 |pmc=7489169 |pmid=32584744}}

Chondrocalcinosis can be visualized on projectional radiography, CT scan, MRI, ultrasound, and nuclear medicine. CT scans and MRIs show calcific masses (usually within the ligamentum flavum or joint capsule), however radiography is more successful. At ultrasound, chondrocalcinosis may be depicted as echogenic foci with no acoustic shadow within the hyaline cartilage.{{cite book | vauthors = Arend CF | title = Ultrasound of the Shoulder | series = Master Medical Books | date = 2013 | chapter = Acromioclavicular chondrocalcinosis | url = http://www.shoulderus.com/ultrasound-of-the-shoulder/acromioclavicular-joint-ultrasound-chondrocalcinosis/ | archive-url = https://web.archive.org/web/20160304034511/http://www.shoulderus.com/ultrasound-of-the-shoulder/acromioclavicular-joint-ultrasound-chondrocalcinosis/ | archive-date = 4 March 2016 | publisher = ShoulderUS.com }} As with most conditions, chondrocalcinosis can present with similarity to other diseases such as ankylosing spondylitis and gout.

{{Heading|Genetics}}

More research is needed on the role of genetics in the development of chondrocalcinosis and CPPD, but there is some evidence that mutations of the ANKH gene may lead to chondrocalcinosis.{{Cite journal |last=Pendleton |first=Adrian |last2=Johnson |first2=Michelle D. |last3=Hughes |first3=Anne |last4=Gurley |first4=Kyle A. |last5=Ho |first5=Andrew M. |last6=Doherty |first6=Michael |last7=Dixey |first7=Josh |last8=Gillet |first8=Pierre |last9=Loeuille |first9=Damien |last10=McGrath |first10=Rodney |last11=Reginato |first11=Antonio |last12=Shiang |first12=Rita |last13=Wright |first13=Gary |last14=Netter |first14=Patrick |last15=Williams |first15=Charlene |date=October 2002 |title=Mutations in ANKH Cause Chondrocalcinosis |url=https://doi.org/10.1086/343054 |journal=The American Journal of Human Genetics |volume=71 |issue=4 |pages=933–940 |doi=10.1086/343054 |issn=0002-9297 |pmc=378546 |pmid=12297987}}

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Category:Radiologic signs