Detection of calcium pyrophosphate dihydrate crystals in knee meniscus by dual-energy computed tomography

Hidenori Tanikawa, Ryo Ogawa, Kazunari Okuma, Kengo Harato, Yasuo Niki, Shu Kobayashi, Takeo Nagura

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Background: Calcium pyrophosphate dihydrate (CPPD) crystals are commonly observed in osteoarthritic joints. The aim of our study was to investigate the efficacy of a dual-energy computed tomography (DECT) for detecting CPPD crystals in knee meniscus. Methods: Twenty-six patients undergoing primary total knee arthroplasty were included in the study. Radiographs of knee joint and synovial fluid specimens were analyzed for the presence of CPPD crystals. Meniscus extracted during surgery was scanned using DECT. Sensitivity and specificity of DECT and radiograph for detecting CPPD crystals were calculated against a reference standard (polarizing light microscopy of synovial fluid aspirate). Meniscus in which CPPD crystals were suspected with DECT was further examined to confirm the crystals using a polarized microscopy. Results: CPPD crystals in synovial fluid were observed in 9 (36%) patients. The sensitivity and specificity of DECT in the detection of CPPD crystals, against microscopic identification, were 77.8 and 93.8%, respectively. The sensitivity and specificity of conventional radiography in the detection of CPPD crystals were 44.4 and 100%, respectively. DECT was able to detect the area where CPPD crystals were deposited in the meniscus. Conclusion: DECT provides good diagnostic sensitivity and specificity for detection of CPPD crystals in knee meniscus as well as spatial information about CPPD crystals. DECT is currently a research tool, but we believe that DECT can be a useful instrument to diagnose CPPD deposition disease, especially for the regions where aspiration is difficult to be performed such as pubic symphysis, atlantoaxial joint, interphalangeal joint.

Original languageEnglish
Article number73
JournalJournal of Orthopaedic Surgery and Research
Volume13
Issue number1
DOIs
Publication statusPublished - 2018 Apr 5

Fingerprint

Calcium Pyrophosphate
Knee
Tomography
Synovial Fluid
Sensitivity and Specificity
Microscopy
Meniscus
Atlanto-Axial Joint
Joints
Pubic Symphysis
Knee Replacement Arthroplasties
Knee Joint
Radiography

Keywords

  • Calcium pyrophosphate
  • Dual-energy computed tomography
  • Knee joint meniscus
  • Pseudogout

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

Detection of calcium pyrophosphate dihydrate crystals in knee meniscus by dual-energy computed tomography. / Tanikawa, Hidenori; Ogawa, Ryo; Okuma, Kazunari; Harato, Kengo; Niki, Yasuo; Kobayashi, Shu; Nagura, Takeo.

In: Journal of Orthopaedic Surgery and Research, Vol. 13, No. 1, 73, 05.04.2018.

Research output: Contribution to journalArticle

@article{ba58fa08308c4ef48975dd490397a5e2,
title = "Detection of calcium pyrophosphate dihydrate crystals in knee meniscus by dual-energy computed tomography",
abstract = "Background: Calcium pyrophosphate dihydrate (CPPD) crystals are commonly observed in osteoarthritic joints. The aim of our study was to investigate the efficacy of a dual-energy computed tomography (DECT) for detecting CPPD crystals in knee meniscus. Methods: Twenty-six patients undergoing primary total knee arthroplasty were included in the study. Radiographs of knee joint and synovial fluid specimens were analyzed for the presence of CPPD crystals. Meniscus extracted during surgery was scanned using DECT. Sensitivity and specificity of DECT and radiograph for detecting CPPD crystals were calculated against a reference standard (polarizing light microscopy of synovial fluid aspirate). Meniscus in which CPPD crystals were suspected with DECT was further examined to confirm the crystals using a polarized microscopy. Results: CPPD crystals in synovial fluid were observed in 9 (36{\%}) patients. The sensitivity and specificity of DECT in the detection of CPPD crystals, against microscopic identification, were 77.8 and 93.8{\%}, respectively. The sensitivity and specificity of conventional radiography in the detection of CPPD crystals were 44.4 and 100{\%}, respectively. DECT was able to detect the area where CPPD crystals were deposited in the meniscus. Conclusion: DECT provides good diagnostic sensitivity and specificity for detection of CPPD crystals in knee meniscus as well as spatial information about CPPD crystals. DECT is currently a research tool, but we believe that DECT can be a useful instrument to diagnose CPPD deposition disease, especially for the regions where aspiration is difficult to be performed such as pubic symphysis, atlantoaxial joint, interphalangeal joint.",
keywords = "Calcium pyrophosphate, Dual-energy computed tomography, Knee joint meniscus, Pseudogout",
author = "Hidenori Tanikawa and Ryo Ogawa and Kazunari Okuma and Kengo Harato and Yasuo Niki and Shu Kobayashi and Takeo Nagura",
year = "2018",
month = "4",
day = "5",
doi = "10.1186/s13018-018-0787-0",
language = "English",
volume = "13",
journal = "Journal of Orthopaedic Surgery and Research",
issn = "1749-799X",
publisher = "BioMed Central",
number = "1",

}

TY - JOUR

T1 - Detection of calcium pyrophosphate dihydrate crystals in knee meniscus by dual-energy computed tomography

AU - Tanikawa, Hidenori

AU - Ogawa, Ryo

AU - Okuma, Kazunari

AU - Harato, Kengo

AU - Niki, Yasuo

AU - Kobayashi, Shu

AU - Nagura, Takeo

PY - 2018/4/5

Y1 - 2018/4/5

N2 - Background: Calcium pyrophosphate dihydrate (CPPD) crystals are commonly observed in osteoarthritic joints. The aim of our study was to investigate the efficacy of a dual-energy computed tomography (DECT) for detecting CPPD crystals in knee meniscus. Methods: Twenty-six patients undergoing primary total knee arthroplasty were included in the study. Radiographs of knee joint and synovial fluid specimens were analyzed for the presence of CPPD crystals. Meniscus extracted during surgery was scanned using DECT. Sensitivity and specificity of DECT and radiograph for detecting CPPD crystals were calculated against a reference standard (polarizing light microscopy of synovial fluid aspirate). Meniscus in which CPPD crystals were suspected with DECT was further examined to confirm the crystals using a polarized microscopy. Results: CPPD crystals in synovial fluid were observed in 9 (36%) patients. The sensitivity and specificity of DECT in the detection of CPPD crystals, against microscopic identification, were 77.8 and 93.8%, respectively. The sensitivity and specificity of conventional radiography in the detection of CPPD crystals were 44.4 and 100%, respectively. DECT was able to detect the area where CPPD crystals were deposited in the meniscus. Conclusion: DECT provides good diagnostic sensitivity and specificity for detection of CPPD crystals in knee meniscus as well as spatial information about CPPD crystals. DECT is currently a research tool, but we believe that DECT can be a useful instrument to diagnose CPPD deposition disease, especially for the regions where aspiration is difficult to be performed such as pubic symphysis, atlantoaxial joint, interphalangeal joint.

AB - Background: Calcium pyrophosphate dihydrate (CPPD) crystals are commonly observed in osteoarthritic joints. The aim of our study was to investigate the efficacy of a dual-energy computed tomography (DECT) for detecting CPPD crystals in knee meniscus. Methods: Twenty-six patients undergoing primary total knee arthroplasty were included in the study. Radiographs of knee joint and synovial fluid specimens were analyzed for the presence of CPPD crystals. Meniscus extracted during surgery was scanned using DECT. Sensitivity and specificity of DECT and radiograph for detecting CPPD crystals were calculated against a reference standard (polarizing light microscopy of synovial fluid aspirate). Meniscus in which CPPD crystals were suspected with DECT was further examined to confirm the crystals using a polarized microscopy. Results: CPPD crystals in synovial fluid were observed in 9 (36%) patients. The sensitivity and specificity of DECT in the detection of CPPD crystals, against microscopic identification, were 77.8 and 93.8%, respectively. The sensitivity and specificity of conventional radiography in the detection of CPPD crystals were 44.4 and 100%, respectively. DECT was able to detect the area where CPPD crystals were deposited in the meniscus. Conclusion: DECT provides good diagnostic sensitivity and specificity for detection of CPPD crystals in knee meniscus as well as spatial information about CPPD crystals. DECT is currently a research tool, but we believe that DECT can be a useful instrument to diagnose CPPD deposition disease, especially for the regions where aspiration is difficult to be performed such as pubic symphysis, atlantoaxial joint, interphalangeal joint.

KW - Calcium pyrophosphate

KW - Dual-energy computed tomography

KW - Knee joint meniscus

KW - Pseudogout

UR - http://www.scopus.com/inward/record.url?scp=85044998623&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85044998623&partnerID=8YFLogxK

U2 - 10.1186/s13018-018-0787-0

DO - 10.1186/s13018-018-0787-0

M3 - Article

VL - 13

JO - Journal of Orthopaedic Surgery and Research

JF - Journal of Orthopaedic Surgery and Research

SN - 1749-799X

IS - 1

M1 - 73

ER -