• 대한영상의학회지
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• 제81권5호
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• pp.1234-1238
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• 2020

칼슘수산화인회석(calcium pyrophosphate dehydrate; 이하 CPPD) 결정침착질환은 연골석회증을 특징으로 하는 질환으로, 주로 무릎, 손목, 골반, 드물게는 척추를 침범한다. 이전 보고에 따르면, CPPD 결정침착은 MRI에서 불균질하게 조영증강이 될 수 있다. 주변 연부 조직의 염증과 동반된 CPPD 결정침착의 뚜렷한 조영증강은 감염성 척추염 등 다른 질환과 유사한 영상 소견을 보일 수 있다. 이 경우 CT는 감별진단에 중요한 역할을 한다. 저자들은 MRI에서 황색인대에 저명한 조영증강을 보이는 CPPD 결정침착 증례를 보고하고자 한다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제40권
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• pp.19.1-19.6
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• 2018

Background: Calcium pyrophosphate dihydrate deposition disease (CPDD) is a rare disease in the temporomandibular joint (TMJ) space. It forms a calcified crystal mass and induces a limitation of joint movement. Case presentation: The calcified mass in our case was occupied in the left TMJ area and extended to the infratemporal and middle cranial fossa. For a complete excision of this mass, we performed a vertical ramus osteotomy and resected the mass around the mandibular condyle. The calcified mass in the infratemporal fossa was carefully excised, and the segmented mandible was anatomically repositioned. Scanning electronic microscopy (SEM)/energy-dispersive X-ray spectroscopy (EDS) microanalysis was performed to evaluate the calcified mass. The result of SEM/EDS showed that the crystal mass was completely composed of calcium pyrophosphate dihydrate. This result strongly suggested that the calcified mass was CPDD in the TMJ area. Conclusions: CPDD in the TMJ is a rare disease and is difficult to differentially diagnose from other neoplasms. A histological examination and quantitative microanalysis are required to confirm the diagnosis. In our patient, CPDD in the TMJ was successfully removed via the extracorporeal approach. SEM/EDS microanalysis was used for the differential diagnosis.

• Clinics in Shoulder and Elbow
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• 제12권1호
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• pp.84-88
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• 2009

목적: 칼슘 피로 인산염 침착질환은 노인에게서 호발하며 젊은 성인에서의 발병은 극히 드문 것으로 인식되어 왔다. 대상 및 방법: 젊은 성인에서 발병한다면 혈색소증, 부갑상선 기능항진증, 저인산혈증, 저마그네슘혈증, 윌슨병, 갑상선 기능저하증, 통풍 등과 관련될 수 있으므로 젊은 성인에서 발병하는 다관절성 칼슘 피로 인산염 침착질환은 대사성 질환에 대한 검사가 이루어져야 한다. 결론: 저자들은 대사성 질환이 없는 25세 젊은 여성에서 발병한 특발성 칼슘 피로 인산염 침착질환 1례를 경험하였기에 보고하는 바이다.

• Asian Spine Journal
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• 제12권6호
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• pp.1117-1122
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• 2018

Study Design: Prospective study. Purpose: To assess the prevalence of periodontoid calcification and its associations with acute cervical pain. Overview of Literature: Calcium pyrophosphate dihydrate (CPPD) deposition disease is a common rheumatological disorder that occurs especially in elderly patients. Although CPPD crystals induce acute arthritis, these crystals are not usually symptomatic. Calcification surrounding the odontoid process (periodontoid calcification) has been reported to induce inflammation, resulting in acute neck pain. This disease is called crowned dens syndrome. Whether calcification induces inflammation or whether the crystals are symptomatic remains unclear. Methods: The prevalence of periodontoid calcification at the atlas transverse ligament was examined by computed tomography of the upper cervical spine in patients suspected of brain disease but no cervical pain (control group, n=296), patients with pseudogout of the peripheral joints but no cervical pain (arthritis group, n=41), and patients with acute neck pain (neck pain group, n=22). Next, the correlation between the prevalence of periodontoid calcification and symptoms was analyzed. Results: In the control group, 40 patients (13.5%) showed periodontoid calcification with no significant difference in the prevalence with gender. The prevalence of calcification increased significantly with age (p=0.002). In the arthritis group, 26 patients (63.4%) reported periodontoid calcification. In the neck pain group, 14 patients (63.6%) reported periodontoid calcification. Multiple logistic regression analysis by age and group revealed that higher age, inclusion in the arthritis group, and inclusion in the neck pain group significantly affected the prevalence of calcification. Conclusions: Our results cumulatively suggest that periodontoid calcification is an aging-related reaction and that calcification per se does not always cause neck pain. Periodontoid calcification was observed more frequently in patients with pseudogout of the peripheral joints and in those with acute neck pain than in asymptomatic control patients.

• 대한영상의학회지
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• 제82권6호
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• pp.1413-1440
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• 2021

MRI에서 추간판의 이상 신호와 위, 아래 척추체 종판의 파괴, 종판 주변의 골수부종 등은 감염성 척추염의 전형적인 소견으로 여겨지나 퇴행성 척추질환, acute Schmorl's node, 척추관절병증, synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO)/chronic recurrent multifocal osteomyelitis, 척추신경관절병증, calcium pyrophosphate dehydrate 결절침착질환 등 다양한 비감염성 척추질환에서도 나타날 수 있다. MRI에서 이러한 비감염성 척추질환과 감별되는 감염성 척추염의 영상 소견은 추간판의 고신호와 농양, 척추 연부조직의의 농양, 그리고 T1 강조영상에서 저신호로 보이는 종판의 경계가 불명확해지는 점 등이다. 그러나 이러한 감별점이 항상 적용되는 것은 아니며 감염성, 비감염성 질환의 영상 소견에 유사점이 많기 때문에 정확한 진단을 위해서는 감염성 척추염뿐만 아니라 감염과 감별해야 하는 다양한 질환의 병태생리와 연관된 영상학적 특징을 아는 것이 중요하다.