The cervical spine in calcium pyrophosphate dihydrate deposition disease. A prevalent case-control study.
OBJECTIVE
To test the hypothesis that calcium pyrophosphate dihydrate (CPPD) deposition disease is a risk factor for neck pain.


METHODS
A prevalent case-control study was conducted to assess cervical calcifications and neck pain between patients with and without known peripheral CPPD deposition disease. CPPD cases were included if diagnosed with CPPD deposition disease of peripheral joints, and excluded if their chief complaint was neck pain. Controls were randomly selected among consecutive patients, hospitalized for conditions unrelated to CPPD deposition disease or neck pain, and matched to CPPD cases by age and sex. Cervical calcifications were assessed by lateral cervical radiographs and computed tomography scans of the upper cervical spine; neck pain and cervical function were appraised by a validated questionnaire.


RESULTS
Cervical calcifications were found in 24 out of 35 patients (69%) in the CPPD group compared to 4 out of 35 patients (11%) in the control group (p < 0.001). Patients with CPPD deposition disease reported significantly more neck pain and discomfort than controls (p < 0.001), and were 5 times more likely to report any neck pain (odds ratio 5.5; 95% confidence interval: 1.9, 21.9). Among male patients, more extensive cervical calcified deposits correlated with more severe neck pain (rs = 0.58, p = 0.03).


CONCLUSIONS
These results suggest that CPPD deposition disease frequently involves the cervical spine and may be associated with the development of neck pain.
Finckh
Axel
A
Rheumatology and Radiology Departments, University Hospital of Vaud (CHUV), Lausanne, Switzerland. afinckh@hsph.harvard.edu
Van Linthoudt
Daniel
D
Duvoisin
Bertrand
B
Bovay
Philippe
P
Gerster
Jean-Charles
JC
D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D002574:Cervical Vertebrae; D002805:Chondrocalcinosis / Q000150:complications / Q000000981:diagnostic imaging / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D019547:Neck Pain / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000209:etiology; D012307:Risk Factors; D016037:Single-Blind Method; D013557:Switzerland / Q000453:epidemiology; D014057:Tomography, X-Ray Computed