A Case of Acute Calcium Pyrophosphate Crystal Arthritis in the Lumbar Facet Joint.
10.4078/jrd.2016.23.2.125
- Author:
Sang Wan CHUNG
1
;
Jong Jin YOO
;
Joon Woo LEE
;
You Jung HA
;
Eun Ha KANG
;
Yeong Wook SONG
;
Yun Jong LEE
Author Information
1. Division of Rheumatology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea. yn35@snu.ac.kr
- Publication Type:Case Report
- Keywords:
Calcium pyrophosphate dihydrate deposition;
Chondrocalcinosis;
Zygapophyseal joint;
Low back pain
- MeSH:
Aged;
Arthralgia;
Arthritis*;
Calcium Pyrophosphate*;
Calcium*;
Chondrocalcinosis;
Diagnosis;
Female;
Fever;
Humans;
Joints;
Knee;
Knee Joint;
Low Back Pain;
Magnetic Resonance Imaging;
Microscopy, Polarization;
Parathyroidectomy;
Radiculopathy;
Spinal Cord Diseases;
Spinal Stenosis;
Synovial Fluid;
Triamcinolone;
Zygapophyseal Joint*
- From:Journal of Rheumatic Diseases
2016;23(2):125-129
- CountryRepublic of Korea
- Language:English
-
Abstract:
Calcium pyrophosphate dihydrate deposition disease most commonly presents with acute arthritis of the peripheral joints. Infrequently, a mass effect of this disease can cause axial symptoms, such as spinal stenosis, radiculopathy, or myelopathy. Herein, we report on the first Korean case of acute arthritis in the lumbar facet joint due to calcium pyrophosphate dihydrate crystal deposition disease. A 73-year-old female presented with acute fever, severe lumbago, and knee arthralgia, 11 days after partial parathyroidectomy. Plain radiographs showed multiple chondrocalcinosis, while a bone scan, computed tomography, and magnetic resonance imaging showed right L5-S1 facet arthritis. In synovial fluid from the facet and knee joints, positively birefringent calcium pyrophosphate dihydrate crystals were observed under polarized light microscopy. Under the diagnosis of acute calcium pyrophosphate dihydrate crystal arthritis (formerly known as 'pseudogout') in the facet joint, an intra-articular triamcinolone injection was administered, which resulted in dramatic improvement of the symptoms within 24 hours.