Diagnostic accuracy of ultrasound, conventional radiography and synovial fluid analysis in the diagnosis of calcium pyrophosphate dihydrate crystal deposition disease

G. Filippou, Antonella Adinolfi, Marco A. Cimmino, Carlo Alberto Scirè, Serafino Carta, Sauro Lorenzini, Pierpaolo Santoro, Luca Maria Sconfienza, I. Bertoldi, V. Picerno, V. Di Sabatino, P. Ferrata, M. Galeazzi, B. Frediani

Research output: Contribution to journalArticle

Abstract

Objective To assess the diagnostic performance of ultrasound (US), x-rays, and microscopic analysis of synovial fluid (SF) for calcium pyrophosphate dihydrate crystal deposition disease (CPPD) using histology as a reference standard Methods We enrolled consecutive patients with osteoarthritis waiting to undergo knee replacement surgery. Each patient underwent US of the knee, focusing on menisci and the hyaline cartilage, the day before surgery. During surgery, SF, menisci and condyles were retrieved and examined microscopically. For the meniscus and cartilage microscopic analysis, 8 samples were collected from each specimen and knee radiographs, performed up to 3 months before surgery, were also assessed. A dichotomous score was given for the presence/absence of CPP for each method. Microscopic findings of the specimens were considered the reference standard. All the procedures followed were in accordance with the ethical standards of the local responsible committee. Results 42 patients (14 males) were enrolled. All patients underwent US, 34 had eligible radiographs and 32 had SF analysis. 25 patients (59.5%) were positive for CPP at US, 15 (44.1%) at X-ray and 14 (43.7%) at SF. Sensitivity and specificity values were 96% and 87% for US, 75% and 93% for radiography and 77% and 100% for SF respectively. There were no statistically significant differences between the diagnostic performance across single tests. Conclusion US proved to be at least as accurate as SF analysis for the diagnosis of CPPD. US, which is feasible and harmless, could be considered the first exam of choice for CPPD diagnosis.

Original languageEnglish
Pages (from-to)254-260
Number of pages7
JournalClinical and Experimental Rheumatology
Volume34
Issue number2
Publication statusPublished - Mar 1 2016

Keywords

  • Calcium pyrophosphate dihydrate deposition disease
  • Chondrocalcinosis
  • Sensitivity and specificity
  • Synovial fluid
  • Ultrasound
  • X-rays

ASJC Scopus subject areas

  • Rheumatology
  • Immunology
  • Immunology and Allergy

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    Filippou, G., Adinolfi, A., Cimmino, M. A., Scirè, C. A., Carta, S., Lorenzini, S., Santoro, P., Sconfienza, L. M., Bertoldi, I., Picerno, V., Di Sabatino, V., Ferrata, P., Galeazzi, M., & Frediani, B. (2016). Diagnostic accuracy of ultrasound, conventional radiography and synovial fluid analysis in the diagnosis of calcium pyrophosphate dihydrate crystal deposition disease. Clinical and Experimental Rheumatology, 34(2), 254-260.