Axial calcium pyrophosphate dihydrate deposition disease revealed by recurrent sterile spondylodiscitis and epidural abscess.
Spondylodiscitis are frequent and clinical challenge for practionners. Axial calcium pyrophosphate dihydrate deposition disease (CPDD) is well known for cervical spine involvement with the crowned dens syndrome but other localisations are probably underdiagnosed in sterile spondylodiscitis. We report a case of recurrent sterile spondylodiscitis with epidural abscess related to CPDD proved by vertebral percutaneous needle biopsy with rapid favourable course under colchicine therapy. Axial CPDD could mimic septic spondylodiscitis with epidural abscess on MRI. Sterile spondylodiscitis are probably underdiagnosed forms of microcrystalline disease. Investigations of the presence of microcrystals should be systematically undertaken with tamponed formalin fixed biopsies. If axial CPDD is suspected, colchicine therapy could be a good therapeutic test and would avoid unnecessary antibiotic treatment.
Rheumatology Department, Clermont-Ferrand University Hospital, CHU Gabriel-Montpied, 58, avenue Montalembert, 63003 Clermont-Ferrand, France. Electronic address: vgrobost@chu-clermontferrand.fr.
Vincent
V
Grobost
Rheumatology Department, Clermont-Ferrand University Hospital, CHU Gabriel-Montpied, 58, avenue Montalembert, 63003 Clermont-Ferrand, France.
Marielle
M
Vayssade
Radiology Department, Clermont-Ferrand University Hospital, CHU Gabriel-Montpied, 58, avenue Montalembert, 63003 Clermont-Ferrand, France.
Antoine
A
Roche
Pathology Department, Clermont-Ferrand University Hospital, CHU Gabriel-Montpied, 58, avenue Montalembert, 63003 Clermont-Ferrand, France.
Jean-Louis
JL
Kemeny
Rheumatology Department, Clermont-Ferrand University Hospital, CHU Gabriel-Montpied, 58, avenue Montalembert, 63003 Clermont-Ferrand, France.
Martin
M
Soubrier
D000369:Aged, 80 and over; D018501:Antirheumatic Agents / Q000627:therapeutic use; D002805:Chondrocalcinosis / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D003078:Colchicine / Q000627:therapeutic use; D015299:Discitis / Q000175:diagnosis* / Q000209:etiology; D020802:Epidural Abscess / Q000175:diagnosis* / Q000209:etiology; D006801:Humans; D008159:Lumbar Vertebrae; D008297:Male; D012008:Recurrence
D018501:Antirheumatic Agents; D003078:Colchicine
Calcium pyrophosphate dihydrate deposition disease; Colchicine therapy; Epidural abscess; Sterile spondylodiscitis