Cervical facet joint chondrocalcinosis

Channel Musculoskeletal

Publication date: October 4, 2013 | Updated on January 16, 2014

Diagnosis

History

Acute neck pain in a 76 year old male

Findings

@1.110, @9.46 CT scans (axial and sagittal view) demonstrate speudo tumoral calcific deposits focused in an enlarged zygapophyseal joint without any soft tissus mass.

DDx

Differential diagnoses below can be considered:

Pyrophosphate crystals deposition are most likely to be seen in the tendons.

Rheumatoid arthritis can lead to facet joint destruction some time associated with

CPPD deposits.

Scleroderma although soft-tissue calcifications are well known to occur

as a late manifestation, symptomatic paraspinal calcinosis is very rare.

Discussion

DEFINITION :

Chondrocalcinosis is a descriptive term, referring to deposition of the pyrophosphate crystal (CPPD). The idiopathic form is the most common form of the process; the prevalence of this condition increases with age . CPPD crystal deposition can be seen in several spinal structures, including intervertebral discs, joint capsules, synovium, articular cartilage, bursae, and ligaments.

CHARACTERISTIC CLINICAL FEATURES AND RADIOLOGIC FINDINGS:

Most patients with calcification of the articular cartilage and intervertebral discs are asymptomatic, althoughthese features can also be responsible for acute cervical speudogout pain. Fibrocartilaginous deposits are thick and irregular and have a shaggy, poorly defined border. CPPD deposition in joint results in erosive and destructive changes.