Faculty Collaboration Database

The prevalence of chondrocalcinosis of the symphysis pubis on CT scan and correlation with calcium pyrophosphate dihydrate crystal deposition disease. Clin Rheumatol 2016 Mar;35(3):771-3

Date

02/11/2016

Pubmed ID

26861035

DOI

10.1007/s10067-016-3193-1

Scopus ID

2-s2.0-84960386582 (requires institutional sign-in at Scopus site)   8 Citations

Abstract

Calcium pyrophosphate dihydrate (CPP) crystal deposition in the articular cartilage can often be seen radiographically as chondrocalcinosis (CC). CPP crystals preferentially deposit in fibrocartilages such as the knee menisci and symphysis pubis (SP). We sought to determine the prevalence of CC in the SP on computed tomography (CT) of the abdomen and pelvis. This retrospective study involved readings on 1070 consecutive CTs of the abdomen and pelvis performed over 3 months in patients over 65 years of age. Medical records of 226 patients found to have CC were reviewed to determine age, gender, documentation of CPPD on problem lists or in medical histories, and whether radiology readings of the CTs mentioned CC. SP CC was identified in 21.1 % (226/1070) of consecutive CT scans with the mean age of CT+ patients being 78.6. Of the 226 patients with SP CC, the observation of CC was documented in only 5.3 % (12/226) of the radiology reports. Of the 12 instances in which the radiology reports mentioned CC, this observation was never (0/12) transmitted to the medical history or problem list. The prevalence of SP CC in patients older than 65 was 21.1 %. Since the majority of CTs of the abdomen and pelvis are not ordered for evaluation of musculoskeletal conditions, this is likely a true prevalence without selection bias. When CC of the SP was present on images, radiologists routinely overlooked or chose not to report CC. Even in the rare instances when it was reported, that information was not added to the medical history or problem list. There are several clinical situations (e.g., acute monoarthritis or atypical osteoarthritis) in which recognizing that a patient has CPP deposition would be useful. Taking the time to review images may yield clinically important findings that are not mentioned anywhere on the patient chart.

Author List

Patel T, Ryan L, Dubois M, Carrera G, Baynes K, Mannem R, Mulkerin J, Visotcky A

Authors

Keith E. Baynes MD Chief, Associate Professor in the Radiology department at Medical College of Wisconsin
Melissa S. DuBois MD Associate Professor in the Radiology department at Medical College of Wisconsin
Rajeev Mannem MD Chief, Associate Professor in the Radiology department at Medical College of Wisconsin
Alexis M. Visotcky Biostatistician III in the Institute for Health and Equity department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Aged
Aged, 80 and over
Chondrocalcinosis
Female
Humans
Knee
Male
Prevalence
Pubic Symphysis
Retrospective Studies
Tomography, X-Ray Computed