title: Do not hallow until you are out of the wood! Ultrasonographic detection of CPP crystal deposits in menisci: facts and pitfalls.
abstract: OBJECTIVE
  Ultrasonography (US) has been demonstrated to be an important tool in the diagnosis of calcium pyrophosphate (CPP) crystal deposition disease. The aim of our study was to individuate and describe possible pitfalls in US detection of such deposits in menisci.
  
  
  METHODS
  We enrolled all patients waiting to undergo knee replacement surgery due to osteoarthritis, for one-month period. Each patient underwent US examination of the knee, focusing on the menisci. After surgery, the menisci were examined by US, macroscopically and microscopically, using the microscopic analysis as the gold standard for CPP deposition.
  
  
  RESULTS
  11 menisci of 6 patients have been studied. Ex vivo examination of menisci performed better in CPP identification than in vivo examination. The possible reasons of misinterpretation or misdiagnosis of the in vivo exam were identified and are extensively described in the paper. Also a new sign of CPP crystal deposits was found.
  
  
  CONCLUSIONS
  This study permitted to highlight some difficulties in CPP crystal detection by US in menisci. Further studies are needed to define completely US CPP crystal aspect and to improve the sensibility and specificity of US in CPP deposition diagnosis.
authors: Department of Medicine, Surgery and Neurosciences, Rheumatology Section, University of Siena, Policlinico le Scotte, Siena, Italy.
authors: Georgios
authors: G
authors: Filippou
authors: Antonella
authors: A
authors: Adinolfi
authors: Panagiotis
authors: P
authors: Bozios
authors: Sauro
authors: S
authors: Lorenzini
authors: Valentina
authors: V
authors: Picerno
authors: Valentina
authors: V
authors: Di Sabatino
authors: Ilaria
authors: I
authors: Bertoldi
authors: Dario
authors: D
authors: Gambera
authors: Mauro
authors: M
authors: Galeazzi
authors: Bruno
authors: B
authors: Frediani
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002131:Calcium Pyrophosphate / Q000032:analysis*; D003460:Crystallization; D005260:Female; D006801:Humans; D008297:Male; D008592:Menisci, Tibial / Q000737:chemistry* / Q000000981:diagnostic imaging; D008875:Middle Aged; D014463:Ultrasonography
chemical_list: D002131:Calcium Pyrophosphate
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