Multilevel calcium pyrophosphate dihydrate deposition in cervical ligamentum flavum: clinical characteristics and imaging features

Abstract Background Involvement in cervical ligamentum flavum is a rare manifestation of the calcium pyrophosphate dihydrate deposition disease. Only few cases of this condition have been reported. We revealed eighteen cases of CPPD in cervical ligamentum flavum that diagnosed at a single medical ce...

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Autores principales:	Yueh-Hsiu Lu, Hsi-Hsien Lin, Hsuan-Ying Chen, Po-Hsin Chou, Shih-Tien Wang, Chien-Lin Liu, Ming-Chau Chang
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Calcium pyrophosphate dihydrate Cervical ligamentum flavum Magnetic resonance imaging Ossification of ligamentum flavum Diseases of the musculoskeletal system RC925-935
Acceso en línea:	https://doaj.org/article/d848bfb7ecc64b67b6c7dd6c087adaed
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spelling	oai:doaj.org-article:d848bfb7ecc64b67b6c7dd6c087adaed2021-11-08T10:58:31ZMultilevel calcium pyrophosphate dihydrate deposition in cervical ligamentum flavum: clinical characteristics and imaging features10.1186/s12891-021-04812-61471-2474https://doaj.org/article/d848bfb7ecc64b67b6c7dd6c087adaed2021-11-01T00:00:00Zhttps://doi.org/10.1186/s12891-021-04812-6https://doaj.org/toc/1471-2474Abstract Background Involvement in cervical ligamentum flavum is a rare manifestation of the calcium pyrophosphate dihydrate deposition disease. Only few cases of this condition have been reported. We revealed eighteen cases of CPPD in cervical ligamentum flavum that diagnosed at a single medical center. In our case series, clinical characteristics and magnetic resonance imaging findings of patients are described. Methods We retrospectively reviewed the medical charts and imaging studies of the eighteen patients with pseudogout attack of the cervical ligamentum flavum. In addition, we discussed the differences between this disease and ossification of ligamentum flavum in image manifestations. Results There were fourteen men and four women aged between 59 and 87 years. Diabetes mellitus and hypertension were the most common comorbidities. Myelopathy and neck pain were presented in most patients. C4–5 and C5–6 were attacked most frequently, and multiple- rather than single-level involvement could be observed in our series. “Acute on chronic phenomenon” was a specific magnetic resonance image finding in patients whose symptom durations were between 2 to 5 months. Compared to ossification of ligamentum flavum, calcium pyrophosphate dihydrate crystal deposition had different image signs, including morphology, side of the involved ligament, no continuity with the lamina, acute on chronic phenomenon, and presence of retro-odontoid mass. Conclusions Nodular calcifications in cervical ligamentum flavum raise highly suspicion for calcium pyrophosphate dihydrate deposition and must be diagnosed by histological examination and polarized light microscopy. This disease is different from ossification of ligamentum flavum, and it could be recognized by specific image features.Yueh-Hsiu LuHsi-Hsien LinHsuan-Ying ChenPo-Hsin ChouShih-Tien WangChien-Lin LiuMing-Chau ChangBMCarticleCalcium pyrophosphate dihydrateCervical ligamentum flavumMagnetic resonance imagingOssification of ligamentum flavumDiseases of the musculoskeletal systemRC925-935ENBMC Musculoskeletal Disorders, Vol 22, Iss 1, Pp 1-9 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Calcium pyrophosphate dihydrate Cervical ligamentum flavum Magnetic resonance imaging Ossification of ligamentum flavum Diseases of the musculoskeletal system RC925-935
spellingShingle	Calcium pyrophosphate dihydrate Cervical ligamentum flavum Magnetic resonance imaging Ossification of ligamentum flavum Diseases of the musculoskeletal system RC925-935 Yueh-Hsiu Lu Hsi-Hsien Lin Hsuan-Ying Chen Po-Hsin Chou Shih-Tien Wang Chien-Lin Liu Ming-Chau Chang Multilevel calcium pyrophosphate dihydrate deposition in cervical ligamentum flavum: clinical characteristics and imaging features
description	Abstract Background Involvement in cervical ligamentum flavum is a rare manifestation of the calcium pyrophosphate dihydrate deposition disease. Only few cases of this condition have been reported. We revealed eighteen cases of CPPD in cervical ligamentum flavum that diagnosed at a single medical center. In our case series, clinical characteristics and magnetic resonance imaging findings of patients are described. Methods We retrospectively reviewed the medical charts and imaging studies of the eighteen patients with pseudogout attack of the cervical ligamentum flavum. In addition, we discussed the differences between this disease and ossification of ligamentum flavum in image manifestations. Results There were fourteen men and four women aged between 59 and 87 years. Diabetes mellitus and hypertension were the most common comorbidities. Myelopathy and neck pain were presented in most patients. C4–5 and C5–6 were attacked most frequently, and multiple- rather than single-level involvement could be observed in our series. “Acute on chronic phenomenon” was a specific magnetic resonance image finding in patients whose symptom durations were between 2 to 5 months. Compared to ossification of ligamentum flavum, calcium pyrophosphate dihydrate crystal deposition had different image signs, including morphology, side of the involved ligament, no continuity with the lamina, acute on chronic phenomenon, and presence of retro-odontoid mass. Conclusions Nodular calcifications in cervical ligamentum flavum raise highly suspicion for calcium pyrophosphate dihydrate deposition and must be diagnosed by histological examination and polarized light microscopy. This disease is different from ossification of ligamentum flavum, and it could be recognized by specific image features.
format	article
author	Yueh-Hsiu Lu Hsi-Hsien Lin Hsuan-Ying Chen Po-Hsin Chou Shih-Tien Wang Chien-Lin Liu Ming-Chau Chang
author_facet	Yueh-Hsiu Lu Hsi-Hsien Lin Hsuan-Ying Chen Po-Hsin Chou Shih-Tien Wang Chien-Lin Liu Ming-Chau Chang
author_sort	Yueh-Hsiu Lu
title	Multilevel calcium pyrophosphate dihydrate deposition in cervical ligamentum flavum: clinical characteristics and imaging features
title_short	Multilevel calcium pyrophosphate dihydrate deposition in cervical ligamentum flavum: clinical characteristics and imaging features
title_full	Multilevel calcium pyrophosphate dihydrate deposition in cervical ligamentum flavum: clinical characteristics and imaging features
title_fullStr	Multilevel calcium pyrophosphate dihydrate deposition in cervical ligamentum flavum: clinical characteristics and imaging features
title_full_unstemmed	Multilevel calcium pyrophosphate dihydrate deposition in cervical ligamentum flavum: clinical characteristics and imaging features
title_sort	multilevel calcium pyrophosphate dihydrate deposition in cervical ligamentum flavum: clinical characteristics and imaging features
publisher	BMC
publishDate	2021
url	https://doaj.org/article/d848bfb7ecc64b67b6c7dd6c087adaed
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_version_	1718442475723423744

Multilevel calcium pyrophosphate dihydrate deposition in cervical ligamentum flavum: clinical characteristics and imaging features

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