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Calcium Pyrophosphate Dihydrate Deposition (CPPD)
Jeffrey S. Ross, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Clinical Issues

          • Diagnostic Checklist

            TERMINOLOGY

            • Abbreviations

              • Calcium pyrophosphate dihydrate deposition (CPPD) disease
            • Definitions

              • Pseudogout: Acute painful episode due to CPPD
                • Terms with "pseudo" should generally be abandoned in favor of CPPD
              • Crowned dens syndrome: Pain due to calcium pyrophosphate crystal deposition around dens

            IMAGING

            • General Features

              • Radiographic Findings

                • CT Findings

                  • MR Findings

                    • Nuclear Medicine Findings

                      • Imaging Recommendations

                        DIFFERENTIAL DIAGNOSIS

                          PATHOLOGY

                          • General Features

                            • Gross Pathologic & Surgical Features

                              • Microscopic Features

                                CLINICAL ISSUES

                                • Presentation

                                  • Demographics

                                    • Treatment

                                      DIAGNOSTIC CHECKLIST

                                      • Consider

                                        • Image Interpretation Pearls

                                          Selected References

                                          1. Ea HK et al: Diagnosis and clinical manifestations of calcium pyrophosphate and basic calcium phosphate crystal deposition diseases. Rheum Dis Clin North Am. 40(2):207-29, 2014
                                          2. Chang EY et al: Frequency of atlantoaxial calcium pyrophosphate dihydrate deposition at CT. Radiology. 269(2):519-24, 2013
                                          3. Tsui FW: Genetics and mechanisms of crystal deposition in calcium pyrophosphate deposition disease. Curr Rheumatol Rep. 14(2):155-60, 2012
                                          4. Zhang W et al: European League Against Rheumatism recommendations for calcium pyrophosphate deposition. Part I: terminology and diagnosis. Ann Rheum Dis. 70(4):563-70, 2011
                                          5. Roverano S et al: Calcification of the transverse ligament of the atlas in chondrocalcinosis. J Clin Rheumatol. 16(1):7-9, 2010
                                          6. Fenoy AJ et al: Calcium pyrophosphate dihydrate crystal deposition in the craniovertebral junction. J Neurosurg Spine. 8(1):22-9, 2008
                                          7. Finckh A et al: The cervical spine in calcium pyrophosphate dihydrate deposition disease. A prevalent case-control study. J Rheumatol. 31(3):545-9, 2004
                                          8. Chen CF et al: Calcium pyrophosphate dihydrate crystal deposition disease in cervical radiculomyelopathy. J Chin Med Assoc. 66(4):256-9, 2003
                                          9. Muthukumar N et al: Tumoral calcium pyrophosphate dihydrate deposition disease of the ligamentum flavum. Neurosurgery. 53(1):103-8; discussion 108-9, 2003
                                          10. Fujishiro T et al: Pseudogout attack of the lumbar facet joint: a case report. Spine. 27(17):E396-8, 2002
                                          11. Steinbach LS et al: Calcium pyrophosphate dihydrate crystal deposition disease: imaging perspectives. Curr Probl Diagn Radiol. 29(6):209-29, 2000
                                          12. Berlemann U et al: Calcium pyrophosphate dihydrate deposition in degenerate lumbar discs. Eur Spine J. 7(1):45-9, 1998
                                          13. Markiewitz AD et al: Calcium pyrophosphate dihydrate crystal deposition disease as a cause of lumbar canal stenosis. Spine. 21(4):506-11, 1996
                                          14. Brown TR et al: Deposition of calcium pyrophosphate dihydrate crystals in the ligamentum flavum: evaluation with MR imaging and CT. Radiology. 178(3):871-3, 1991
                                          15. el-Khoury GY et al: Massive calcium pyrophosphate crystal deposition at the craniovertebral junction. AJR Am J Roentgenol. 145(4):777-8, 1985
                                          Related Anatomy
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                                          Related Differential Diagnoses
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                                          References
                                          Tables

                                          Tables

                                          KEY FACTS

                                          • Terminology

                                            • Imaging

                                              • Top Differential Diagnoses

                                                • Clinical Issues

                                                  • Diagnostic Checklist

                                                    TERMINOLOGY

                                                    • Abbreviations

                                                      • Calcium pyrophosphate dihydrate deposition (CPPD) disease
                                                    • Definitions

                                                      • Pseudogout: Acute painful episode due to CPPD
                                                        • Terms with "pseudo" should generally be abandoned in favor of CPPD
                                                      • Crowned dens syndrome: Pain due to calcium pyrophosphate crystal deposition around dens

                                                    IMAGING

                                                    • General Features

                                                      • Radiographic Findings

                                                        • CT Findings

                                                          • MR Findings

                                                            • Nuclear Medicine Findings

                                                              • Imaging Recommendations

                                                                DIFFERENTIAL DIAGNOSIS

                                                                  PATHOLOGY

                                                                  • General Features

                                                                    • Gross Pathologic & Surgical Features

                                                                      • Microscopic Features

                                                                        CLINICAL ISSUES

                                                                        • Presentation

                                                                          • Demographics

                                                                            • Treatment

                                                                              DIAGNOSTIC CHECKLIST

                                                                              • Consider

                                                                                • Image Interpretation Pearls

                                                                                  Selected References

                                                                                  1. Ea HK et al: Diagnosis and clinical manifestations of calcium pyrophosphate and basic calcium phosphate crystal deposition diseases. Rheum Dis Clin North Am. 40(2):207-29, 2014
                                                                                  2. Chang EY et al: Frequency of atlantoaxial calcium pyrophosphate dihydrate deposition at CT. Radiology. 269(2):519-24, 2013
                                                                                  3. Tsui FW: Genetics and mechanisms of crystal deposition in calcium pyrophosphate deposition disease. Curr Rheumatol Rep. 14(2):155-60, 2012
                                                                                  4. Zhang W et al: European League Against Rheumatism recommendations for calcium pyrophosphate deposition. Part I: terminology and diagnosis. Ann Rheum Dis. 70(4):563-70, 2011
                                                                                  5. Roverano S et al: Calcification of the transverse ligament of the atlas in chondrocalcinosis. J Clin Rheumatol. 16(1):7-9, 2010
                                                                                  6. Fenoy AJ et al: Calcium pyrophosphate dihydrate crystal deposition in the craniovertebral junction. J Neurosurg Spine. 8(1):22-9, 2008
                                                                                  7. Finckh A et al: The cervical spine in calcium pyrophosphate dihydrate deposition disease. A prevalent case-control study. J Rheumatol. 31(3):545-9, 2004
                                                                                  8. Chen CF et al: Calcium pyrophosphate dihydrate crystal deposition disease in cervical radiculomyelopathy. J Chin Med Assoc. 66(4):256-9, 2003
                                                                                  9. Muthukumar N et al: Tumoral calcium pyrophosphate dihydrate deposition disease of the ligamentum flavum. Neurosurgery. 53(1):103-8; discussion 108-9, 2003
                                                                                  10. Fujishiro T et al: Pseudogout attack of the lumbar facet joint: a case report. Spine. 27(17):E396-8, 2002
                                                                                  11. Steinbach LS et al: Calcium pyrophosphate dihydrate crystal deposition disease: imaging perspectives. Curr Probl Diagn Radiol. 29(6):209-29, 2000
                                                                                  12. Berlemann U et al: Calcium pyrophosphate dihydrate deposition in degenerate lumbar discs. Eur Spine J. 7(1):45-9, 1998
                                                                                  13. Markiewitz AD et al: Calcium pyrophosphate dihydrate crystal deposition disease as a cause of lumbar canal stenosis. Spine. 21(4):506-11, 1996
                                                                                  14. Brown TR et al: Deposition of calcium pyrophosphate dihydrate crystals in the ligamentum flavum: evaluation with MR imaging and CT. Radiology. 178(3):871-3, 1991
                                                                                  15. el-Khoury GY et al: Massive calcium pyrophosphate crystal deposition at the craniovertebral junction. AJR Am J Roentgenol. 145(4):777-8, 1985