Condrocalcinosa - Diagnosis

Laboratory studies:Erythrocyte-sedimentation rate is high, leukocytosis observedThe young patients will Evel hemochromatosis, hyperparathyroidism, hypothyroidism-Evaluation of serum calcium, phosphorus, magnesium and alkaline phosphataseThe measurement of iron, transferrin saturation and ferritin, thyroid hormones-Performing polarized light microscopy after aspiration of fluid from the affected joint, the crystals are rhomboid, weakly positive birefringence and difficult to see.
Imaging Studies:Routine radiograph demonstrates pathology. Calcifications is recognized by hyaline cartilage or fibrous structures that appear dense on X-ray as a line parallel to the surface in articular hyaline cartilage. It is similar to a calcified sheath that reflects the articular surface as a concrete surface white, hard, 3-4 mm thick in the subchondral articular surface. The disease can mimic rheumatoid arthritis and osteoarthritis primary imaging. While radiocarpiene and metacarpal phalange joints are not affected in osteoarthritis, the lesions present in these locations are highly suggestive condrocalcinoza. You notice a large subchondral cysts.Pseudoreumatoida form of the disease is erosive. The condition is suggested by degenerative osteoarthritis with unusual locations such as shoulder and elbow that do not support the weight.Identatiile radiocarpiene joint collapse and joint space with sclerosis indicate disease Calcium pyrophosphate storage.
Computed tomography showed calcified masses with typical lobe configuration in yellow ligament or joint capsule. The observed mass of low density septal areas. Pressure erosions can be seen with disruption of bone cortex. Fine granular calcifications are also seen. Subchondral cysts or erosions and fractures that may be present.
Diagnostic criteria for storage disease Calcium pyrophosphate:Criterion I-show storage of calcium pyrophosphate in synovial tissue or fluid by X-rays, or chemical analysis difractionalaCriterion IIa-positive identification of crystals without birefringence with polarized light microscopyCriterion IIb-this typical radiographic calcificationsCriterion-IIIa acute arthritis of the knee and other large jointsCriterion-IIIb chronic arthritis of the knee, hip, wrist, carpienelor, elbow, shoulder, accompanied by acute exacerbations with unusual locations, subchondral cyst formation, severe degeneration, osteophytes formation, tendon calcifications.
Histological examination: Histological changes described in storage disease calcium pyrophosphate and calcium deposits correspond to Cartilage inflammation. These are nonspecific, but condrocartilaj calcium deposits are the most typical feature in these patients. Pathognomonic feature is seen in polarized microscopy showing rhomboid crystals, intracellular, weakly positive birefringence.
The differential diagnosis is been completed with the following conditions: ankylosing spondylitis, gout, skeletal hiperosteoza broadcast, meniscus cracks, neuropathic arthropathy, Osgood-Schlatter disease, osteoarthritis, osteocondromatoza, osteosarcoma, rheumatoid arthritis, septic arthritis, spinal stenosis, osteochondritis dissecans, synovial osteocondromatoza