Prevalence Of Chondrocalcinosis Research Articles

High prevalence of chondrocalcinosis and frequent comorbidity with calcium pyrophosphate deposition disease in patients with seronegative rheumatoid arthritis

BackgroundThe crystal-induced calcium pyrophosphate deposition disease (CPPD) clinically appearing as pseudogout differs from the mere radiographic finding of chondrocalcinosis (CC) but may cause symptoms resembling rheumatoid arthritis (RA).ObjectiveTo study the...

Calcium pyrophosphate crystal deposition in a cohort of 57 patients with Gitelman syndrome.

Gitelman syndrome (GS) is the most frequent salt-wasting genetic tubulopathy and a source of hypokalaemia and hypomagnesemia. Chondrocalcinosis (CC) is a frequent feature of GS. The aim of our study was to determine the prevalence, distribution patterns, clinical phenotypes and risk factors for CC in GS. This prospective study of a cohort of 57 patients with GS included a systematic screening for CC by peripheral joint radiography, cervical spine CT and joint US. The prevalence of cervical C1-C2 CC by CT was compared between 33 GS patients and sex- and age-matched controls. Clinical and biochemical features were analysed to identify factors associated with CC. Mean (s.d.) age of patients was 46.5 (12.4) years, 66.7% were women and 93.0% carried SLC12A3 mutations. Mean serum magnesium level was 0.60 (0.30) mmol/l. CC was observed in 79% of patients, with the highest prevalence at the cervical spine (81.8%) followed by the knee (52.6%), wrist (50.9%), ankle (38.6%), TM joint (36.4%), shoulder (33.3%), hip (22.8%), elbow (14.0%) and sclerochoroid (12.1%). Prevalence of CC at the C1-C2 level was higher in the GS cohort than control group (72.7% vs 9.1%) (adjusted odds ratio 21.0, 95% CI 2.8, 156.1, P = 0.003). Independent factors associated with CC were low serum magnesium level and age. GS was associated with widespread CC, favoured by aging and hypomagnesemia. The C1-C2 level was the most affected site. Follow-up of this unique cohort will help understanding the clinical consequences of CC, especially the precise characterization of pyrophosphate arthropathy.

Prevalence of chondrocalcinosis in the temporomandibular joint in patients with chondrocalcinosis of the knee or wrist.

The aim of this study was to investigate the prevalence of TMJ chondrocalcinosis on head CT scans in patients with chondrocalcinosis of the knee or wrist. 227 patients with radiological evidence of calcifications on knee or wrist radiographs had a head CT scan obtained for unrelated purposes. CT scans were retrospectively reviewed for the presence of temporomandibular crystal deposition. Prevalence, bilaterality, age and gender distribution were determined. 41 of 227 (18%) of patients had TMJ chondrocalcinosis. TMJ chondrocalcinosis was more common in females (17%) than males (1%). It was more commonly unilateral (68%) than bilateral (32%). In patients with peripheral calcific disease, the TMJ is more commonly involved than previously reported and this is more common in females compared to males.

VITAMIN K ANTAGONISM AND CHONDROCALCINOSIS IN THE OSTEOARTHRITIS INITIATIVE

Calcification of articular cartilage, known as chondrocalcinosis, becomes more prevalent with age. Although chondrocalcinosis can be characteristic of osteoarthritis, it has been associated with more joint pain and disability independent of osteoarthritis severity. Identifying novel modifiable risk factors for chondrocalcinosis may help reduce joint pain and disability. One potential risk factor involves vitamin K because vitamin K-dependent proteins that inhibit calcification are present in articular cartilage. To test the hypothesis that vitamin K antagonism is associated with more chondrocalcinosis, we evaluated the cross-sectional association between warfarin use and chondrocalcinosis prevalence in the Osteoarthritis Initiative (n=1472, 60% female, mean age 64 years). Warfarin is a vitamin K antagonist that interferes with vitamin K-dependent protein function. In a secondary analysis we evaluated whether the prevalence of chondrocalcinosis differed according to dietary vitamin K intake. Chondrocalcinosis of the knee, evaluated using plain x-rays, was detected in 8% of participants. It was three times more prevalent in warfarin users (n=20) compared to non-users [prevalence ratio (95% confidence interval) (PR(95%CI)): 3.02(1.42-6.46); p=0.004, adjusted for age, sex, race, BMI]. Chondrocalcinosis prevalence did not differ according to vitamin K intake [PR(95%CI), compared to tertile 3 (≥189 mcg/d): tertile 1 (<96 mcg/d) =1.30(0.82-2.07), tertile 2 (96-189 mcg/d) =1.17(0.76-1.81), p-trend=0.623, adjusted for age, sex, race, BMI, energy intake]. That chondrocalcinosis prevalence differed according to warfarin use, but not vitamin K intake, suggests vitamin K-dependent protein function may be involved in chondrocalcinosis development. Since warfarin was not commonly used in this cohort, additional studies are needed to substantiate our findings.

Prevalence of chondrocalcinosis in a Mexican tertiary care institution of musculoskeletal disorders.

The prevalence of chondrocalcinosis (CC) was reported as variable according to the geographic populations. However, there are no data regarding its prevalence in Mexico. Thus, we decided to investigate the Mexican prevalence of CC in a cohort of patients from a tertiary health care institution. A retrospective analysis of radiographs of knees and wrists from our institution was performed. Inclusion criteria included patients > 50years old having radiographs of knees and wrists. Radiographic presence of CC was classified according to a dichotomous evaluation assayed by two rheumatologists experts on the area. A total of 3.350 radiographs from 1.602 patients were evaluated. Forty-seven patients showed calcifications in at least one knee or wrist for an overall prevalence of 3%, of which 23.4% were men and 76.6% women. The knee was more commonly affected than the wrist (85.1% and 14.9% respectively). The prevalence according to gender was 2.9% in women, whereas, it was 3.2% in men. Only two patients (4.3%) showed a contemporaneous presence of CC in both hands and both knees. At knee level, the prevalence was 2.7%, whereas at the wrist, we reported a prevalence of 4.9%. The prevalence of CC for Mexican population had not been reported so far. This a starting point to break the silence and encourage the knowledge of how this disease is associated with possible risk factors in Mexican population. Key Points •The prevalence of chondrocalcinosis in Mexico was 3%. •The prevalence of knee chondrocalcinosis increases according to the age in women's. •The nixtamalized meals could be a protective factor for CC in Mexican population.

Low prevalence of knee chondrocalcinosis and its catabolic association with serum matrix metalloproteinase 3: A rural Japanese population study.

This study aimed to elucidate the prevalence of radiographic knee chondrocalcinosis (CC) and to clarify whether CC is correlated with self-reported knee symptoms and a serum catabolic biomarker. A total of 1278 volunteers participated. Plain radiographs of both knees were obtained. Identification of a linear calcification in the knee joint space was defined as CC. Patients with a Kellgren-Lawrence grade of 2 or more were considered to have knee osteoarthritis (OA). Symptoms were evaluated using the Knee injury and Osteoarthritis Outcome Score (KOOS) Pain scale, and serum matrix metalloproteinase-3 (MMP-3) concentration was determined. Multiple regression analysis was conducted to determine whether CC was correlated with OA, the KOOS Pain scale and MMP-3 concentration. Twenty-eight subjects were found to have CC (2.2%), and 389 had OA (30.4%). CC was correlated with OA (odds ratio: 5.797; P = 0.006). Additionally, CC was correlated with MMP-3 concentration (B = 11.415, β = 0.059, P = 0.014), but not with KOOS Pain scale. The prevalence of CC was low in the Japanese population evaluated in this study. While CC was not correlated with self-reported knee symptoms, it was positively correlated with serum MMP-3 concentration.

Prevalence of Chondrocalcinosis in Patients above 50 Years and the Relationship with Osteoarthritis.

Background:Some studies showed a relation between chondrocalcinosis and osteoarthritis (OA). Hence, considering the importance of chondrocalcinosis diagnosis andnecessity for its integration with OA, the current study aims at investigating prevalence of chondrocalcinosis in patients above 50 years admitted to Isfahan Al-Zahra Medical Center and its relationship with OA.Materials and Methods:In a cross-sectional study, 600 patients who referred to the radiology units of Al-Zahra Hospital for radiography of different joints were studied during 2013–2014. The patients images were studied for chondrocalcinosis and OA by a radiologist and also examined clinically and results of imaging by an expert rheumatologist. The prevalence of chondrocalcinosis and it relation with OA was determined by Statistical Package for Social Sciences software and using of Chi-square and t-test.Results:23 patients under study had chondrocalcinosis (3.83%). patients with chondrocalcinosis had higher age average, and they were in age group of 70 years and older, but no significant difference was observed regarding the prevalence of the disease in both genders. Chondrocalcinosis prevalence in terms of body mass index showed significant differences (P = 0.001). All patients with chondrocalcinosis had a history of joint disease and prevalence of chondrocalcinosis in terms of joint disease history showed a significant difference (P < 0.001).Conclusion:Prevalence of chondrocalcinosis is relatively high in the Iranian population of 70 years and older. Hence, more investigation considering to the diagnosis of chondrocalcinosis among patients with OA is very important.

Calcium pyrophosphate deposition disease: a review of epidemiologic findings.

The purpose of this review is to summarize the recent advances in the epidemiology of calcium pyrophosphate deposition disease (CPPD), and to discuss their implications. This review is particularly timely as several epidemiological studies that enhance the understanding of CPPD have been published recently. This article will review recent findings on the prevalence of chondrocalcinosis; discuss new data on the associations between bone mineral density and chondrocalcinosis; and between diuretic use, chronic kidney disease 5 and 'pseudogout' (now termed acute calcium pyrophosphate crystal arthritis). It will summarize findings from a large dataset which reported that chondrocalcinosis results from a systemic predisposition, and that the association between chondrocalcinosis and polymorphisms in ANKH gene is independent of age and osteoarthritis. It will also review recent data which suggest that the association between chondrocalcinosis and osteoarthritis may be joint specific, and that chondrocalcinosis associates with radiographic attrition in knees with osteoarthritis. The studies reviewed suggest that CPPD occurs due to a generalized predisposition, and that it modifies the radiographic phenotype of osteoarthritis. However, further research is required to confirm if CPPD modifies the clinical phenotype of osteoarthritis.

The prevalence of chondrocalcinosis of the symphysis pubis on CT scan and correlation with calcium pyrophosphate dihydrate crystal deposition disease.

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.

FRI0379 Chondrocalcinosis frequently occurs at the wrists and hips in the absence of knee involvement

BackgroundThe prevalence of chondrocalcinosis (CC) using radiographs of the three areas commonly affected by CC (knees, hips, wrists) has been examined in small studies which provide conflicting information as to...

The prevalence of chondrocalcinosis (CC) of the acromioclavicular (AC) joint on chest radiographs and correlation with calcium pyrophosphate dihydrate (CPPD) crystal deposition disease

Digital imaging combined with picture archiving and communication system (PACS) access allows detailed image retrieval and magnification. Calcium pyrophosphate dihydrate (CPPD) crystals preferentially deposit in fibrocartilages, the cartilage of the acromioclavicular (AC) joint being one such structure. We sought to determine if examination of the AC joints on magnified PACS imaging of chest films would be useful in identifying chondrocalcinosis (CC). Retrospective radiographic readings and chart reviews involving 1,920 patients aged 50 or more who had routine outpatient chest radiographs over a 4-month period were performed. Knee radiographs were available for comparison in 489 patients. Medical records were reviewed to abstract demographics, chest film reports, and diagnoses. AC joint CC was identified in 1.1% (21/1,920) of consecutive chest films. Patients with AC joint CC were 75years of age versus 65.4 in those without CC (p < 0.0002). Four hundred eighty-nine patients had knee films. Six of these patients had AC joint CC, and of these, five also had knee CC (83%). Of the 483 without AC joint CC, 62 (12%) had knee CC (p = 0.002). Patients with AC joint CC were more likely to have a recorded history of CPPD crystal deposition disease than those without AC joint CC (14 versus 1%, p = 0.0017). The prevalence of AC joint CC increases with age and is associated with knee CC. A finding of AC joint CC should heighten suspicion of pseudogout or secondary osteoarthritis in appropriate clinical settings and, in a young patient, should alert the clinician to the possibility of an associated metabolic condition.

Epidemiology of gout and chondrocalcinosis

Gout is the most common cause of inflammatory arthritis affecting at least 1% of the population in industrialized countries. It is closely associated with hyperuricemia and is characterized by formation and reversible deposition of monosodium urate crystals in joints and extra-articular tissues. Several studies suggest that the prevalence and incidence of gout are rising. Numerous risk factors may in part explain this increasing trend including dietary and lifestyle changes, genetic factors, diuretic use and comorbid conditions such as hypertension, diabetes, cardiovascular disease, chronic renal disease and the metabolic syndrome. Chondrocalcinosis is characterized by the deposition of calcium pyrophosphate crystals in articular tissues, most commonly fibrocartilage and hyaline cartilage. Sporadic chondrocalcinosis is a common condition in the elderly and frequently associates with osteoarthritis. Hereditary haemochromatosis, hyperparathyroidism and hypomagnesaemia are metabolic disorders that predispose to secondary chondrocalcinosis.The prevalence of chondrocalcinosis is still rather uncertain and varies depending on the diagnostic criterion used in different studies.

An update on the epidemiology of calcium pyrophosphate dihydrate crystal deposition disease

The aim of this review is to summarize recent research relating to the epidemiology of chondrocalcinosis (CC), including prevalence of CC, the association between CC and OA, familial forms of CC and diseases associated with CC. We searched MEDLINE for articles published in English from 1998 to 2008 using MEsH terms covering all aspects of the epidemiology of CC. Aging is the main risk factor for the occurrence of sporadic CC. Prevalence of CC varies from 7 to 10% in people aged approximately 60 years and shows equal sex distribution. There is a positive association between CC and OA, but CC does not appear to be a risk factor for subsequent structural progression in terms of cartilage loss. Mutations in the ankylosis human (ANKH) gene have been identified as a cause of familial CC in some kindreds. There is good evidence that hereditary haemochromatosis, hyperparathyroidism and hypomagnesaemia are metabolic disorders that predispose to secondary CC. In conclusion, sporadic CC is a common condition in the elderly and frequently associates with OA. Primary metabolic disorders or familial predisposition are uncommon but should be considered if CC occurs before 55 years of age or if there is florid polyarticular CC. After the age of 55 years, hyperparathyroidism should be considered in all patients.

Hypomagnesemia associated with chondrocalcinosis: A cross‐sectional study

To determine an association between magnesium (Mg) depletion and chondrocalcinosis, which has been reported but not investigated in a cross-sectional study. Prevalence of chondrocalcinosis was investigated in 144 individuals: 72 patients receiving home parenteral nutrition (HPN) compared with 72 age- and sex-matched controls. Presence of chondrocalcinosis was assessed by knee radiographs. Blood serum and globular Mg levels and 24-hour urinary Mg content were compared. Mean +/- SD age for both patients and controls was 51 +/- 17 years, and 51% in both groups were women. Mean duration of HPN was 6.4 years. Prevalence of chondrocalcinosis was markedly higher in patients receiving HPN than controls (16.6% versus 2.7%; P = 0.006, odds ratio [OR] 7.0, 95% confidence interval [95% CI] 1.45-66.1). Mean +/- SD serum and globular Mg levels were significantly lower in patients than controls (serum: 0.75 +/- 0.09 mmoles/liter versus 0.81 +/- 0.08 mmoles/liter, P = 0.0006; globular Mg: 1.8 +/- 0.31 mmoles/liter versus 2.0 +/- 0.35 mmoles/liter, P = 0.0003). Twenty-four-hour urinary Mg level was lower in patients than controls (mean +/- SD 3.85 +/- 1.50 mmoles versus 5.37 +/- 3.71 mmoles; P = 0.001). Prevalence of chondrocalcinosis was significantly higher in patients with a low serum Mg level (OR 13.5, 95% CI 2.76-127.3, P < 0.0001), with a similarly high but not significant occurrence of chondrocalcinosis in patients with a low globular Mg level (OR 4.09, 95% CI 0.603-20.26, P = 0.08) and in patients with a low 24-hour urinary Mg level (OR 3.9, 95% CI 0.77-16.34, P = 0.05). Long-lasting Mg depletion is strongly associated with chondrocalcinosis.

Analysis of the association between chondrocalcinosis and osteoarthritis: a community based study.

To analyse the association between chondrocalcinosis and osteoarthritis (OA) of the hands and knees in an unselected elderly rural population. A community based cross sectional study was performed in individuals randomly selected from a previous epidemiological survey on the prevalence of chondrocalcinosis in people older than 60 years from Osona county, Catalonia, northeastern Spain. Radiological OA (grade 2 or more of Kellgren's classification) was evaluated in 26 individuals with chondrocalcinosis and in 104 controls. A total of 18 articular areas of both knees (medial and lateral tibiofemoral compartments) and hands (first, second and third metacarpophalangeal (MCP), first carpometacarpal, trapezium-scaphoid, radiocarpal and distal radioulnar joints) were studied. Radiological changes of OA in the knees were more common in subjects with chondrocalcinosis than in those without it, with an odds ratio adjusted for age and gender (aOR) of 4.3 (95% confidence interval (CI) 1.6 to 11.8, p = 0.005). OA was also more frequent in almost all areas of the hands in individuals with chondrocalcinosis, though the difference reached statistical significance only in the MCP joints (aOR 3.1; 95% CI 1.1 to 8.8; p = 0.033). However, taking into account the side and the different joint compartments analysed, the association between chondrocalcinosis and OA was significant only in the lateral tibiofemoral compartment and the left MCP joints. In an elderly population unselected for their rheumatic complaints, there was a real association between OA and chondrocalcinosis. This association was particularly relevant in the lateral tibiofemoral compartment of the knee and in the first three left MCP joints.

Does hypothyroidism increase the prevalence of chondrocalcinosis?

To investigate whether or not there is an association between hypothyroidism (HPT) and chondrocalcinosis (CC) 100 HPT patients and 100 controls matched for the age and sex were evaluated prospectively. All the patients were examined clinically, and X-rays of knees, wrists and pelvis, and biological evaluation of thyroid hormones, calcium, uric acid, iron and alkaline phosphatase levels were recorded. X-rays were assessed independently by two radiologists blind to the thyroid status of the patient. The prevalence of CC was 17% in the HPT patients and 10% in the controls (NS). No correlation was found between CC duration and mechanism or treatment of HPT. We suggest that HPT and CC are two diseases that may co-exist in patients but without any causal or mechanistic relationship.

Prevalence of Chondrocalcinosis in Patients with Primary Hyperparathyroidism in Japan.

One hundred and thirty-two consecutive patients with primary hyperparathyroidism were studied preoperatively for the presence of chondrocalcinosis, the roentgenographic marker of calcium pyrophosphate dihydrate (CPPD) crystal deposition disease, by obtaining radiographs of knees, wrists and pelvis. Chondrocalcinosis was found in 8 patients (6.1%), each of whom was over 50 years of age. In 72 of the patients over 50 years of age, the prevalence of chondrocalcinosis in the hyperparathyroid patients (11.1%) was greater than that found in 72 control patients (2.8%) with thyroid nodular disease who were exactly matched for age and sex, but the difference was not significant. The prevalence of chondrocalcinosis in the hyperparathyroid patients sharply increased with age. In the group in their 50's it was 4.4%, rising to 15.8% in patients in their 60's and reaching 37.5% for those over 70 years of age. Patients with chondrocalcinosis were significantly older than those without this finding (p < 0.005). Those with chondrocalcinosis also had significantly higher preoperative serum calcium levels than those without it (p < 0.05). While chondrocalcinosis was detected by taking joint radiographs in all patients with primary hyperparathyroidism, acute arthritis (pseudogout attack) occurred in only 2 of the 132 patients (1.5%) after parathyroidectomy, but this represents 25% (2 of 8) of those who had chondrocalcinosis. An attack of pseudogout may therefore be one of the most common postoperative complications of parathyroid surgery in the elderly. Considering the low incidence of pseudogout attack following parathyroidectomy, preoperative radiological studies of the knee joints are sufficient to screen for chondrocalcinosis and are recommended for patients over 60 years old in Japan.(ABSTRACT TRUNCATED AT 250 WORDS)

Prevalence of knee chondrocalcinosis in hospital and clinic patients aged 50 or older.

The prevalence of chondrocalcinosis was studied in 574 hospital and clinic patients aged 50 or older who had undergone x-ray examination of the knee. Chondrocalcinosis was found in 9.6 percent of all these patients, in 5 percent of the 50-64 age group, and in 14.6 percent of the 65-94 age group. The prevalence of knee chondrocalcinosis increased in stepwise fashion between the ages of 65 and 80. A review of the literature and of the data on our few patients over the age of 80 suggests the existence of an even higher prevalence among persons of this advanced age group.