Abstract
BackgroundInvolvement in cervical ligamentum flavum is a rare manifestation of the calcium pyrophosphate dihydrate deposition disease. Only few cases of this condition have been reported. We revealed eighteen cases of CPPD in cervical ligamentum flavum that diagnosed at a single medical center. In our case series, clinical characteristics and magnetic resonance imaging findings of patients are described.MethodsWe retrospectively reviewed the medical charts and imaging studies of the eighteen patients with pseudogout attack of the cervical ligamentum flavum. In addition, we discussed the differences between this disease and ossification of ligamentum flavum in image manifestations.ResultsThere were fourteen men and four women aged between 59 and 87 years. Diabetes mellitus and hypertension were the most common comorbidities. Myelopathy and neck pain were presented in most patients. C4–5 and C5–6 were attacked most frequently, and multiple- rather than single-level involvement could be observed in our series. “Acute on chronic phenomenon” was a specific magnetic resonance image finding in patients whose symptom durations were between 2 to 5 months. Compared to ossification of ligamentum flavum, calcium pyrophosphate dihydrate crystal deposition had different image signs, including morphology, side of the involved ligament, no continuity with the lamina, acute on chronic phenomenon, and presence of retro-odontoid mass.ConclusionsNodular calcifications in cervical ligamentum flavum raise highly suspicion for calcium pyrophosphate dihydrate deposition and must be diagnosed by histological examination and polarized light microscopy. This disease is different from ossification of ligamentum flavum, and it could be recognized by specific image features.
Highlights
Calcium pyrophosphate dihydrate (CPPD) crystal deposition disease, known as pseudogout, was first described by Zinan and Sitaj in 1958 [1]
In the presented case series, we report 18 patients with calcification of cervical ligamentum flavum who required surgical treatment and were confirmed to suffer from CPPD deposition disease by pathologic diagnosis
Compared with previous reports which discussed the findings of pathophysiology, laboratory tests, clinical manifestation, computed tomography (CT) scan, and various pathological studies, our report showed magnetic resonance imaging (MRI) findings and other clinical characteristics
Summary
Calcium pyrophosphate dihydrate (CPPD) crystal deposition disease, known as pseudogout, was first described by Zinan and Sitaj in 1958 [1]. In the presented case series, we report 18 patients with calcification of cervical ligamentum flavum who required surgical treatment and were confirmed to suffer from CPPD deposition disease by pathologic diagnosis. Compared with previous reports which discussed the findings of pathophysiology, laboratory tests, clinical manifestation, computed tomography (CT) scan, and various pathological studies, our report showed magnetic resonance imaging (MRI) findings and other clinical characteristics. Involvement in cervical ligamentum flavum is a rare manifestation of the calcium pyrophosphate dihy‐ drate deposition disease. Clinical characteristics and magnetic resonance imaging findings of patients are described
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
