Elsevier

Clinical Imaging

Volume 26, Issue 3, May–June 2002, Pages 194-196
Clinical Imaging

Knee chondrocalcinosis: An ultrasonographic study of the hyalin cartilage

https://doi.org/10.1016/S0899-7071(01)00385-0Get rights and content

Abstract

Purpose: The purpose of the present research was to test the diagnostic value of ultrasonography (US) to detect chondrocalcinosis in the hyalin cartilage (HC). Method: This was tested on both knees of 21 selected patients with a history of unilateral HC and 19 controls. In Group, I (US), evaluation was performed on selected knees. The selection was based on the evidence of HC on previous radiographs. In Group II, US examination of the contralateral side of the same cohort was performed first and radiographic picture was done as a second step. Results: Ultrasonically, detectable calcification was present in 17 of 21 in Groups I and II, respectively. The US findings of the latter were confirmed on radiographs in 15. The sensitivity and specificity of Groups I and II were 80–100% and 89–91%, respectively. The overall sensitivity and specificity of US in calcification verification in HC proved to be 89% and 90%. Popliteal cyst was detected in 10 cases of which 8 showed evidence of calcification in the bursal fluid. Typical calcium pyrophosphate dihydrate (CPPD) crystals could be demonstrated in five of those. Conclusion: US is a valuable, sensitive and specific method in the evaluation of patients with chondrocalcinosis and crystal deposition disease.

Introduction

Up until now, the diagnosis of chondrocalcinosis and CPPD disease have been based mainly on radiographic or microscopic detection of the typical crystals and clinical manifestation of arthritic “pseudogout” attacks [1], [2], [3].

Crystal deposition (calcium pyrophosphate dihydrate (CPPD), basic calcium phosphate) may cause bursitis and tendinits, fever and pain nor silent cases are uncommon [4]. Other consequences such as tendon calcification may occur as well. Prospective, controlled study has shown that, for example, gastrocnemius tendon calcification is an accurate radiographic marker of chondrocalcinosis in patients with knee pain [5]. Ultrasound (US) is a versatile tool in musculoskeletal imaging. US is very sensitive in showing echogenic foci in and around the joint. Because there is only scanty information [6], [7], [8] in the literature about the importance of US in the evaluation of patients with chondrocalcinosis our target was to test this patient population in a controlled study.

Section snippets

Method

Both knees of the 21 selected patients with a history of unilateral knee chondrocalcinosis were examined in the National Institute of Rheumatology, Budapest, Hungary and in the Institute of Pulmonology of Nograd, Hungary in a controlled study.

The evaluated cohort consisted of 14 women and 7 men (mean age 55.6 years, age range 39–76 years) and the control group consisted of 19 patients older than 50 years with mild osteoarthritis and without chondrocalcinosis on radiographs (2 males, 15 females,

Results

Ultrasonically detectable calcification was present in 17 of 21 selected HC knees (Group I) and in 17 of the Group II. The later findings were confirmed on radiographs in 15. The sensitivity and specificity of Groups I and II was 80–100% and 89–91%, respectively. The overall sensitivity and specificity (combined Groups I and II) of US to detect calcification in HC proved to be 89% and 90% (Table 1). It is of interest that we observed HC posteriorly more often (26 of 32).

Popliteal cyst was

Discussion

Hyalin chondrocalcinosis and calcium pyrophosphate deposition in and around the joints are often associated with knee pain. The sensitivity of plain radiographs to detect soft tissue changes or calcification may vary though earlier studies have shown that for example musculus gastrocnemius tendon calcification is a useful marker of chondrocalcinosis and the association between chondrocalcinosis and this tendon calcification is strong. This is important because physical examination has little or

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