Issa Wasim, Mercer Ronald, Yinh Janeth, Guermazi Ali, Jarraya Mohamed
Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 32 Fruit Street, Yawkey 6044, Boston, MA, 02114, USA.
Division of Rheumatology, Allergy, and Immunology, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Skeletal Radiol. 2025 Jan 8. doi: 10.1007/s00256-024-04859-1.
The radiological manifestations of calcium pyrophosphate deposition (CPPD) revolve around two main axes: the asymptomatic form and CPPD disease. The latter is a consequence of an immune response to calcium phosphate crystals. Chondrocalcinosis is broadly considered the radiographic manifestation of CPPD regardless of whether it is asymptomatic or associated with inflammatory arthritis. CPPD is associated with osteoarthritis although the direction of such association is still unclear. Apart from the detection of CPP crystals in synovial fluid, imaging (mainly conventional radiography and increasingly ultrasound) plays a central role in the diagnosis of CPPD disease. Recently, CT has been added as a diagnostic tool, especially in deep anatomic locations such as crowned dens. To date, no treatment is effective in dissolving CPP crystals. For now, the focus of current treatment strategies remains inflammation control. Our aim is to review the epidemiology, pathogenesis, and clinical and imaging manifestations of asymptomatic and symptomatic CPPD. We will also discuss recent consensus definitions and classifications of CPPD disease.
焦磷酸钙沉积（CPPD）的放射学表现主要围绕两个方面：无症状形式和CPPD疾病。后者是对磷酸钙晶体免疫反应的结果。无论是否无症状或与炎性关节炎相关，软骨钙质沉着症广泛被认为是CPPD的放射学表现。CPPD与骨关节炎相关，尽管这种关联的方向仍不明确。除了在滑液中检测到CPP晶体外，影像学检查（主要是传统放射摄影，超声检查的应用也越来越多）在CPPD疾病的诊断中起着核心作用。最近，CT也被用作一种诊断工具，尤其是在诸如齿突等深部解剖部位。迄今为止，尚无治疗方法能有效溶解CPP晶体。目前，当前治疗策略的重点仍然是控制炎症。我们的目的是综述无症状和有症状CPPD的流行病学、发病机制、临床及影像学表现。我们还将讨论CPPD疾病最近的共识定义和分类。
