Calcium pyrophosphate dihydrate crystal deposition in and around the atlantoaxial joint: Association with type 2 odontoid fractures in nine patients

Yousuke Kakitsubata, Robert D Boutin, Daphne J. Theodorou, Roger M. Kerr, Lynne S. Steinbach, Karence K. Chan, Mini N. Pathria, Parviz Haghighi, Donald Resnick

Research output: Contribution to journalArticle

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Abstract

PURPOSE: To investigate the histopathologic anatomy of calcium pyrophosphate dihydrate (CPPD) crystal deposition in and around the atlantoaxial joint and the association between CPPD crystal deposition and subchondral cysts, erosions, and fracture involving the odontoid process of the axis. MATERIALS AND METHODS: One adult cadaver demonstrating calcification in the retro-odontoid area at computed tomography (CT) was selected for further radiography, CT, and magnetic resonance (MR) imaging at the C1-2 level. Anatomic sectioning and histologic evaluations were performed in the specimen. For clinical study, radiographs (n = 5), CT scans (n = 8), and MR images (n = 6) in nine patients (mean age, 74.4 years) with odontoid process fractures and CPPD crystal deposits in and around the atlantoaxial joint were reviewed. RESULTS: In the cadaveric specimen, radiography and CT demonstrated calcifications in the transverse ligament; histologic evaluation confirmed that these calcifications were CPPD crystal deposits. In all nine patients, radiography (n = 5) and CT (n = 8) also showed calcification in areas adjacent to the odontoid process, which included the transverse ligament. T1- and T2-weighted MR imaging showed a retro-odontoid mass of low signal intensity that compressed the cervical cord in six patients. CT, MR imaging, or both demonstrated subchondral cysts, osseous erosions, or a type 2 odontoid fracture in all patients. CONCLUSION: CPPD crystal deposition disease involving the C1-C2 articulation can be a clinically important entity that may place affected patients at increased risk of pathologic fracture of the odontoid process.

Original languageEnglish (US)
Pages (from-to)213-219
Number of pages7
JournalRadiology
Volume216
Issue number1
StatePublished - 2000

Fingerprint

Atlanto-Axial Joint
Chondrocalcinosis
Odontoid Process
Tomography
Calcium Pyrophosphate
Radiography
Bone Cysts
Magnetic Resonance Imaging
Ligaments
Spontaneous Fractures
Cadaver
Anatomy
Magnetic Resonance Spectroscopy

Keywords

  • Arthritis
  • Atlas and axis, fractures
  • Calcium pyrophosphate dihydrate deposition disease (CPPD)
  • Fractures, pathologic
  • Ligaments, spinal
  • Spine, CT
  • Spine, MR

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology

Cite this

Kakitsubata, Y., Boutin, R. D., Theodorou, D. J., Kerr, R. M., Steinbach, L. S., Chan, K. K., ... Resnick, D. (2000). Calcium pyrophosphate dihydrate crystal deposition in and around the atlantoaxial joint: Association with type 2 odontoid fractures in nine patients. Radiology, 216(1), 213-219.

Calcium pyrophosphate dihydrate crystal deposition in and around the atlantoaxial joint : Association with type 2 odontoid fractures in nine patients. / Kakitsubata, Yousuke; Boutin, Robert D; Theodorou, Daphne J.; Kerr, Roger M.; Steinbach, Lynne S.; Chan, Karence K.; Pathria, Mini N.; Haghighi, Parviz; Resnick, Donald.

In: Radiology, Vol. 216, No. 1, 2000, p. 213-219.

Research output: Contribution to journalArticle

Kakitsubata, Y, Boutin, RD, Theodorou, DJ, Kerr, RM, Steinbach, LS, Chan, KK, Pathria, MN, Haghighi, P & Resnick, D 2000, 'Calcium pyrophosphate dihydrate crystal deposition in and around the atlantoaxial joint: Association with type 2 odontoid fractures in nine patients', Radiology, vol. 216, no. 1, pp. 213-219.
Kakitsubata, Yousuke ; Boutin, Robert D ; Theodorou, Daphne J. ; Kerr, Roger M. ; Steinbach, Lynne S. ; Chan, Karence K. ; Pathria, Mini N. ; Haghighi, Parviz ; Resnick, Donald. / Calcium pyrophosphate dihydrate crystal deposition in and around the atlantoaxial joint : Association with type 2 odontoid fractures in nine patients. In: Radiology. 2000 ; Vol. 216, No. 1. pp. 213-219.
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abstract = "PURPOSE: To investigate the histopathologic anatomy of calcium pyrophosphate dihydrate (CPPD) crystal deposition in and around the atlantoaxial joint and the association between CPPD crystal deposition and subchondral cysts, erosions, and fracture involving the odontoid process of the axis. MATERIALS AND METHODS: One adult cadaver demonstrating calcification in the retro-odontoid area at computed tomography (CT) was selected for further radiography, CT, and magnetic resonance (MR) imaging at the C1-2 level. Anatomic sectioning and histologic evaluations were performed in the specimen. For clinical study, radiographs (n = 5), CT scans (n = 8), and MR images (n = 6) in nine patients (mean age, 74.4 years) with odontoid process fractures and CPPD crystal deposits in and around the atlantoaxial joint were reviewed. RESULTS: In the cadaveric specimen, radiography and CT demonstrated calcifications in the transverse ligament; histologic evaluation confirmed that these calcifications were CPPD crystal deposits. In all nine patients, radiography (n = 5) and CT (n = 8) also showed calcification in areas adjacent to the odontoid process, which included the transverse ligament. T1- and T2-weighted MR imaging showed a retro-odontoid mass of low signal intensity that compressed the cervical cord in six patients. CT, MR imaging, or both demonstrated subchondral cysts, osseous erosions, or a type 2 odontoid fracture in all patients. CONCLUSION: CPPD crystal deposition disease involving the C1-C2 articulation can be a clinically important entity that may place affected patients at increased risk of pathologic fracture of the odontoid process.",
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T1 - Calcium pyrophosphate dihydrate crystal deposition in and around the atlantoaxial joint

T2 - Association with type 2 odontoid fractures in nine patients

AU - Kakitsubata, Yousuke

AU - Boutin, Robert D

AU - Theodorou, Daphne J.

AU - Kerr, Roger M.

AU - Steinbach, Lynne S.

AU - Chan, Karence K.

AU - Pathria, Mini N.

AU - Haghighi, Parviz

AU - Resnick, Donald

PY - 2000

Y1 - 2000

N2 - PURPOSE: To investigate the histopathologic anatomy of calcium pyrophosphate dihydrate (CPPD) crystal deposition in and around the atlantoaxial joint and the association between CPPD crystal deposition and subchondral cysts, erosions, and fracture involving the odontoid process of the axis. MATERIALS AND METHODS: One adult cadaver demonstrating calcification in the retro-odontoid area at computed tomography (CT) was selected for further radiography, CT, and magnetic resonance (MR) imaging at the C1-2 level. Anatomic sectioning and histologic evaluations were performed in the specimen. For clinical study, radiographs (n = 5), CT scans (n = 8), and MR images (n = 6) in nine patients (mean age, 74.4 years) with odontoid process fractures and CPPD crystal deposits in and around the atlantoaxial joint were reviewed. RESULTS: In the cadaveric specimen, radiography and CT demonstrated calcifications in the transverse ligament; histologic evaluation confirmed that these calcifications were CPPD crystal deposits. In all nine patients, radiography (n = 5) and CT (n = 8) also showed calcification in areas adjacent to the odontoid process, which included the transverse ligament. T1- and T2-weighted MR imaging showed a retro-odontoid mass of low signal intensity that compressed the cervical cord in six patients. CT, MR imaging, or both demonstrated subchondral cysts, osseous erosions, or a type 2 odontoid fracture in all patients. CONCLUSION: CPPD crystal deposition disease involving the C1-C2 articulation can be a clinically important entity that may place affected patients at increased risk of pathologic fracture of the odontoid process.

AB - PURPOSE: To investigate the histopathologic anatomy of calcium pyrophosphate dihydrate (CPPD) crystal deposition in and around the atlantoaxial joint and the association between CPPD crystal deposition and subchondral cysts, erosions, and fracture involving the odontoid process of the axis. MATERIALS AND METHODS: One adult cadaver demonstrating calcification in the retro-odontoid area at computed tomography (CT) was selected for further radiography, CT, and magnetic resonance (MR) imaging at the C1-2 level. Anatomic sectioning and histologic evaluations were performed in the specimen. For clinical study, radiographs (n = 5), CT scans (n = 8), and MR images (n = 6) in nine patients (mean age, 74.4 years) with odontoid process fractures and CPPD crystal deposits in and around the atlantoaxial joint were reviewed. RESULTS: In the cadaveric specimen, radiography and CT demonstrated calcifications in the transverse ligament; histologic evaluation confirmed that these calcifications were CPPD crystal deposits. In all nine patients, radiography (n = 5) and CT (n = 8) also showed calcification in areas adjacent to the odontoid process, which included the transverse ligament. T1- and T2-weighted MR imaging showed a retro-odontoid mass of low signal intensity that compressed the cervical cord in six patients. CT, MR imaging, or both demonstrated subchondral cysts, osseous erosions, or a type 2 odontoid fracture in all patients. CONCLUSION: CPPD crystal deposition disease involving the C1-C2 articulation can be a clinically important entity that may place affected patients at increased risk of pathologic fracture of the odontoid process.

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KW - Atlas and axis, fractures

KW - Calcium pyrophosphate dihydrate deposition disease (CPPD)

KW - Fractures, pathologic

KW - Ligaments, spinal

KW - Spine, CT

KW - Spine, MR

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