DOI: http://dx.doi.org/10.18203/2349-2902.isj20191911

Rare case of pseudogout in the scapular region

Zenina Reuben Andrews, T. Mohanapriya, K. Balaji Singh

Abstract


Calcium pyrophosphate dihydrate crystal deposition disease (CPPD) also referred to as pseudogout is an inflammatory arthritis produced by the deposition of calcium pyrophosphate crystals in the synovium and periarticular soft tissues. This report documents a case of a 41 year old female who presented with a painful swelling in the back. MRI revealed a complex swelling with lobulation of size 7.4×7.4×7 cm in the posterolateral aspect of chest wall just superficial to the ribcage. A surgical excision biopsy of the swelling was done and patient improved symptomatically. Serum uric acid levels were measured and found to be within limits.


Keywords


CPPD, Periarticular, Pseudogout

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References


Rosenthal AK, Ryan LM. Calcium pyrophosphate deposition disease. N Engl J Med. 2016374:2575-84.

Pritzker KPH, Phillips H, Luk SC, Koven IH, Kiss A, Houpt JB. Pseudotumor of temporomandibular joint: destructive calcium pyrophosphate dihydratearthropathy. J Rheumatol. 1976;3:70-81.

Leisen JCC, Austd ED, Bluhm GB, Sigler JW. The tophus in calcium pyrophosphate deposition disease. JAMA. 1980;244: 1711-2.

Gibson JP, Roenigk WJ. Pseudogout in a dog. J Am Vet Med Assoc. 1972;161:912-5.

Crystal induced arthritis, Chapter 25: Rheumatology and Bone Disease, Davidson’s Principles and Practice of Medicine 22nd edition.

Liu-Bryan R, Pritzker K, Firestein GS, Terkeltaub R. TLR2 signaling in chondrocytes drives calcium pyrophosphate dihydrate and monosodium urate crystal–induced nitric oxide generation. J Immunol. 2005;174:5016-23.

Reuben PM, Wenger L, Cruz M, Cheung HS. Induction of matrix metalloproteinase-8 in human fibroblasts by basic calcium phosphate and calcium pyrophosphate dihydrate crystals: effect of phosphocitrate. Connect Tissue Res. 2001;42:1-12.

Muehleman C, Li J, Aigner T, Rappoport L, Mattson E, Hirschmugl C, et al. Association between crystals and cartilage degeneration in the ankle. The J rheumatol. 2008;35(6):1108-17.

Rosen T, Furman J. Acute calcium pyrophosphate deposition arthropathy. JAAPA. 2016;29:1-3.

Macmullan PMc, Carthy G. Treatment and management of pseudogout: insights for the clinician. Ther Adv Musculoskelet Dis. 2012;4:121-31.

Rosenthal, AK, Ryan LM. Calcium pyrophosphate crystal deposition disease; pseudogout; articular chondrocalcinosis. In: WJ Koopman, editor. Arthritis and Allied Conditions. 14th ed. Philadelphia: Lea and Febiger. 2001;2348-71.

Felson DT, Anderson JJ, Naimark A, Kannel W, Meenan RF. The prevalence of chondrocalcinosis in the elderly andits association with knee osteoarthritis: the Framingham Study. J Rheumatol 1989;16:1241-5.

Mitrovic DR, Stankovic A, Iriarte-Borda O, UzanM, Quintero M, Miravet L, et al. The prevalence of chondrocalcinosis in the human knee joint. An autopsy survey. JRheumatol. 1988;15:633-41.

Jones AC, Chuck AJ, Arie EA, Green DJ, Doherty M. Diseases associated with calcium pyrophosphate deposition disease. Semin Arthritis Rheum. 1992; 22:188-202.

Nakagawa Y, Ishibashi K, Kobayashi K, Westesson PL. Calcium pyrophosphate disease in the temporomandibular joint: report of two cases. J Oral Maxillofac Surg. 1999;57:1357-63.

Ishida T, Dorfman HD, Bullough PG. Tophaceous pseudogout (tumoral calcium pyrophosphate dihydrate crystal deposition dis-ease). Hum Pathol. 1995;6:587-93.

Nicholas BD, Smith JL, Kellman RM. Calcium pyrophosphate deposition of the temporomandibular joint with massive bonyerosion. J Oral Maxillofac Surg. 2007;65:2086-9.

Alvarellos A, Spilberg I. Colchicine prophylaxis in pseudogout. J Rheumatol. 1986;13:804-5.

Doherty M, Dieppe P, Watt I. Pyrophosphate arthropathy: a prospective study. Br J Rheumatol. 1993;32:189-96.