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 language | English (US) |
|---|---|
| Pages (from-to) | 213-219 |
| Number of pages | 7 |
| Journal | Radiology |
| Volume | 216 |
| Issue number | 1 |
| State | Published - 2000 |
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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
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 journal › Article
}
TY - JOUR
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.
KW - Arthritis
KW - Atlas and axis, fractures
KW - Calcium pyrophosphate dihydrate deposition disease (CPPD)
KW - Fractures, pathologic
KW - Ligaments, spinal
KW - Spine, CT
KW - Spine, MR
UR - http://www.scopus.com/inward/record.url?scp=0033932244&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0033932244&partnerID=8YFLogxK
M3 - Article
C2 - 10887250
AN - SCOPUS:0033932244
VL - 216
SP - 213
EP - 219
JO - Radiology
JF - Radiology
SN - 0033-8419
IS - 1
ER -