Basic calcium phosphate deposition disease – a clinical and imaging analysis
Romanian Journal of Rheumatology
Background. Basic calcium phosphate (BCP) deposition disease is a frequent musculoskeletal problem characterized by the intraarticular or periarticular deposition of carbonate substituted hydroxyapatite, octacalcium phosphate and tricalcium phosphate. BCP and calcium pyrophosphate (CPP) crystals play an important role in the pathogenesis of osteoarthritis. Objectives. The primary aim was to evaluate the clinical and ultrasonographic characteristics of patients with BCP. The secondary aim was to
... econdary aim was to compare the radiographic scores of patients with BCP, calcium pyrophosphate dihydrate (CPPD) deposition disease and degenerative disease (DD). Material and methods. 50 patients with BCP deposition disease diagnosed by imaging or by identification of BCP in synovial fluid (SF) were included in the study. The second part of the study included 20 patients with BCP crystals in SF, 20 patients with CPP crystals in SF and 20 patients with degenerative changes on radiography and without crystals in SF. Clinical, ultrasonographic and radiographic data were recorded. Results. The shoulder joint (56%), followed by the knee joint (36%) and the acute clinical presentation (84%) were the most common findings. The fragmented ultrasound appearance (54%) was the most frequent, followed by the arch-shaped (36%). The localization of the deposits was found most often in the tendons (68%), mainly in the supraspinatus tendon (55.88%). Higher K/L scores were found in patients with BCP and CPP crystals than in the patients with DD. K/L score ≥3, defining osteoarthritis was associated with the presence of BCP and CPP crystals. Conclusions. The shoulder and the fragmented ultrasound pattern are the most common findings in patients with BCP. Higher K/L scores are found in patients with BCP and CPP crystal associated disease than in the degenerative disease patients.