Foldes K, Lenchik L, Jaovisidha S, Clopton P, Sartoris D J, Resnick D
Department of Radiology, Veterans Administration Medical Center (VAMC), San Diego, CA 92161, USA.
Skeletal Radiol. 1996 Oct;25(7):621-4. doi: 10.1007/s002560050147.
Chondrocalcinosis of the knee is a common radiological finding in the elderly. However, visualization of chondrocalcinosis may be difficult in patients with advanced cartilage loss. The purpose of this study was to determine sensitivity, specificity, and accuracy of gastrocnemius tendon calcification that might serve as a radiographic marker of chondrocalcinosis in patients with painful knees.
We prospectively evaluated 37 knee radiographs in 30 consecutive patients (29 men, 8 women; mean age 67 years, age range 37-90 years) with painful knees who had radiographic evidence of chondrocalcinosis. The frequency of fibrocartilage, hyaline cartilage, and gastrocnemius tendon calcification was determined. For a control group, we evaluated knee radiographs in 65 consecutive patients with knee pain (54 men, 11 women; mean age 59 years, age range 40-93 years) who had no radiological signs of chondrocalcinosis. The frequency of gastrocnemius tendon calcification in the control group was determined.
Gastrocnemius tendon calcification was 41% sensitive, 100% specific, and 78% accurate in predicting chondrocalcinosis. The gastrocnemius tendon was calcified on 15 of 37 (41%) radiographs in the experimental group and on 0 of 67 radiographs in the control group. In the chondrocalcinosis group, 23 (62%) had posterior hyaline cartilage calcification, 14 (38%) had anterior hyaline cartilage calcification, 31 (84%) had medial meniscus calcification, and 36 (97%) had lateral meniscus calcification.
Our results show that gastrocnemius tendon calcification is an accurate radiographic marker of chondrocalcinosis in patients with knee pain.
膝关节软骨钙质沉着症是老年人常见的影像学表现。然而，对于软骨严重缺失的患者，软骨钙质沉着症的显影可能困难。本研究的目的是确定腓肠肌腱钙化作为疼痛性膝关节患者软骨钙质沉着症影像学标志物的敏感性、特异性和准确性。
我们前瞻性评估了30例连续的膝关节疼痛患者（29例男性，8例女性；平均年龄67岁，年龄范围37 - 90岁）的37张膝关节X线片，这些患者有软骨钙质沉着症的影像学证据。确定纤维软骨、透明软骨和腓肠肌腱钙化的发生率。对于对照组，我们评估了65例连续的膝关节疼痛患者（54例男性，11例女性；平均年龄59岁，年龄范围40 - 93岁）的膝关节X线片，这些患者无软骨钙质沉着症的影像学征象。确定对照组中腓肠肌腱钙化的发生率。
腓肠肌腱钙化在预测软骨钙质沉着症方面的敏感性为41%，特异性为100%，准确性为78%。实验组37张X线片中15张（41%）出现腓肠肌腱钙化，对照组67张X线片中无1例出现。在软骨钙质沉着症组中，23例（62%）有后透明软骨钙化，14例（38%）有前透明软骨钙化，31例（84%）有内侧半月板钙化，36例（97%）有外侧半月板钙化。
我们的结果表明，腓肠肌腱钙化是膝关节疼痛患者软骨钙质沉着症的准确影像学标志物。
