Frequency of Atlantoaxial Calcium Pyrophosphate Dihydrate Deposition at CT

Abstract

To determine (a) the prevalence of atlantoaxial calcium pyrophosphate dihydrate (CPPD) crystal deposition in a population of patients undergoing computed tomography (CT) for acute trauma and (b) the association between atlantoaxial CPPD crystal deposition and retro-odontoid soft-tissue thickness. This HIPAA-compliant study was approved by the institutional review board, and the requirement to obtain informed consent was waived. In 513 consecutive patients, CT scans of the cervical spine obtained for acute trauma were retrospectively reviewed for the presence of atlantoaxial CPPD crystal deposition, and the maximal thickness of the retro-odontoid soft tissues was measured. The relationships among imaging findings, age, and sex were assessed with the t test, the χ(2) test, Spearman correlation, and logistic and linear regression models as appropriate. The overall prevalence of atlantoaxial CPPD crystal deposition was 12.5% (64 of 513 patients), and prevalence increased with age (P < .0001, logistic regression coefficient). In patients aged 60 years and older, the prevalence of CPPD crystal deposition was 34% (58 of 170 patients). In patients aged 80 years and older, the prevalence of CPPD crystal deposition was 49% (37 of 75 patients). There was a positive correlation between age and retro-odontoid soft-tissue thickness (Spearman ρ = 0.48, P < .0001). The mean retro-odontoid soft-tissue thickness in patients with CPPD crystal deposition was greater than that in patients without CPPD crystal deposition (3.4 mm vs 2.2 mm, respectively; P < .0001, t test). CPPD crystal deposition in the cervical spine is seen with a higher prevalence than previously reported. CPPD crystal deposition shows a positive correlation with age and retro-odontoid soft-tissue thickening.