Greca Indrit, Ben Gabr Jihad, Perl Andras, Bryant Stephanie, Zaccarini Dan
SUNY Upstate University Hospital, Syracuse, NY-13210, USA.
Departments of Medicine, Microbiology and Immunology, Biochemistry and Molecular Biology, State University of New York, UMU, College of Medicine, New York, USA.
Case Rep Rheumatol. 2020 Feb 10;2020:3218350. doi: 10.1155/2020/3218350. eCollection 2020.
Inflammatory arthritis, such as pseudogout or otherwise referred to as calcium pyrophosphate (CPP) crystal arthritis or calcium pyrophosphate deposition (CPPD) disease, is characterized by the deposition of crystal formation and deposition in large joints. CPPD is known to affect the elderly population and commonly manifests as inflammation of knees, hips, and shoulders. CPPD disease involving the spine has been infrequently encountered in practice and rarely described in the literature. Here, we describe a case of an 80-year-old female with no known history of inflammatory arthritis who presented with left lower extremity weakness and fall, initially thought to have discitis, later confirming CPPD of the spine through biopsy and ultimately resolution of symptoms with anti-inflammatory agents. Although consisting of different clinical presentations, two other case reports have described CPPD of the spine with similar radiographic findings, to this author's knowledge. With the radiologic similarities, this unique case serves to raise awareness in the medical community and possibly place pseudogout of the spine on the differential list when such cases are encountered. As a result, patients can be initiated on benign anti-inflammatory agents, avoiding invasive testing and unnecessary antibiotic exposure.
炎性关节炎,如假性痛风,或也被称为焦磷酸钙(CPP)晶体关节炎或焦磷酸钙沉积(CPPD)病,其特征是在大关节中形成晶体并沉积。已知CPPD会影响老年人群,通常表现为膝盖、臀部和肩部的炎症。在实际临床中,涉及脊柱的CPPD病很少见,在文献中也很少被描述。在此,我们报告一例80岁女性,既往无炎性关节炎病史,以左下肢无力和跌倒为表现,最初被认为患有椎间盘炎,后来通过活检确诊为脊柱CPPD,最终使用抗炎药后症状缓解。据作者所知,尽管有其他两例病例报告描述了具有相似影像学表现的脊柱CPPD,但临床表现各异。鉴于影像学上的相似性,这个独特的病例有助于提高医学界的认识,并可能在遇到此类病例时将脊柱假性痛风列入鉴别诊断清单。这样一来,患者可以开始使用良性抗炎药,避免进行侵入性检查以及不必要的抗生素暴露。