title: The prevalence of chondrocalcinosis (CC) of the acromioclavicular (AC) joint on chest radiographs and correlation with calcium pyrophosphate dihydrate (CPPD) crystal deposition disease.
abstract: Digital imaging combined with picture archiving and communication system (PACS) access allows detailed image retrieval and magnification. Calcium pyrophosphate dihydrate (CPPD) crystals preferentially deposit in fibrocartilages, the cartilage of the acromioclavicular (AC) joint being one such structure. We sought to determine if examination of the AC joints on magnified PACS imaging of chest films would be useful in identifying chondrocalcinosis (CC). Retrospective radiographic readings and chart reviews involving 1,920 patients aged 50 or more who had routine outpatient chest radiographs over a 4-month period were performed. Knee radiographs were available for comparison in 489 patients. Medical records were reviewed to abstract demographics, chest film reports, and diagnoses. AC joint CC was identified in 1.1 % (21/1,920) of consecutive chest films. Patients with AC joint CC were 75 years of age versus 65.4 in those without CC (p < 0.0002). Four hundred eighty-nine patients had knee films. Six of these patients had AC joint CC, and of these, five also had knee CC (83 %). Of the 483 without AC joint CC, 62 (12 %) had knee CC (p = 0.002). Patients with AC joint CC were more likely to have a recorded history of CPPD crystal deposition disease than those without AC joint CC (14 versus 1 %, p = 0.0017). The prevalence of AC joint CC increases with age and is associated with knee CC. A finding of AC joint CC should heighten suspicion of pseudogout or secondary osteoarthritis in appropriate clinical settings and, in a young patient, should alert the clinician to the possibility of an associated metabolic condition.
authors.affiliation: Division of Rheumatology, Medical College of Wisconsin, 9200 West Wisconsin Avenue, Milwaukee, WI 53226, USA. kparperis@mcw.edu
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Parperis
authors.forename: Guillermo
authors.initials: G
authors.lastname: Carrera
authors.forename: Keith
authors.initials: K
authors.lastname: Baynes
authors.forename: Alan
authors.initials: A
authors.lastname: Mautz
authors.forename: Melissa
authors.initials: M
authors.lastname: Dubois
authors.forename: Ross
authors.initials: R
authors.lastname: Cerniglia
authors.forename: Lawrence M
authors.initials: LM
authors.lastname: Ryan
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D002131:Calcium Pyrophosphate / Q000737:chemistry*; D002805:Chondrocalcinosis / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology*; D002968:Clavicle / Q000000981:diagnostic imaging*; D003460:Crystallization; D005260:Female; D006801:Humans; D007596:Joints / Q000503:physiopathology*; D007719:Knee Joint / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000175:diagnosis; D015995:Prevalence; D013902:Radiography, Thoracic; D012189:Retrospective Studies
chemical_list: D002131:Calcium Pyrophosphate