HIGH FREQUENCY OF STRUCTURAL DAMAGE IN THE LOWER SPINE OF PATIENTS WITH CHONDROCALCINOSIS
Authors: Klavdianou K et al.
Calcium pyrophosphate deposition disease (CPPD) is known to affect fibrocartilaginous tissue in the large and smaller peripheral joints. The affection of similar structures in the axial skeleton is unclear. In this retrospective study patients with known CPPD and conventional radiographs (CR) and if available MRI of the spine were compared to non CPPD patients with degenerative disc disease (DDD).
The conventional radiographs (CR) segments T7/8-L5/S1 were evaluated for the occurrence of disc calcification, intradiscal vacuum phenomenon, disc height, endplate erosion, osteophytes and spondylolisthesis, the MRIs for occurrence of vacuum phenomena, endplate erosion, Modic changes and disc dehydration.
CR of 140 patients with CPPD and 99 with DDD were evaluated (mean age 74.4±9.9 and 71±6.2, 20% vs. 20.2% males, respectively). MRIs of the spine were available from 48 CPPD and 44 DDD patients. Vacuum phenomena, disc calcification, osteophytes and erosion were significantly more frequently seen in patients with CPPD compared to DDD. When comparing MRIs, a higher number of discovertebral units were affected by vacuum phenomena and endplate erosions in CPPD patients.
Patients with chondrocalcinosis showed more severe and progressive degenerative findings in the lower spine as assessed by both, CR and MRI, in comparison to established DDD. This data shows that disease manifestations of CPPD in the axial skeleton are clinically relevant.
Clinically interesting are inflammatory episodes of CPPD in the spine which can mimic septic spondylodiscitis.