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Journal of Orthopaedic Surgery and Research
Published in: Journal of Orthopaedic Surgery and Research 1/2018

Open Access 01-12-2018 | Research article

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

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

Published in: Journal of Orthopaedic Surgery and Research | Issue 1/2018

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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.
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Metadata
Title
Detection of calcium pyrophosphate dihydrate crystals in knee meniscus by dual-energy computed tomography
Authors
Hidenori Tanikawa
Ryo Ogawa
Kazunari Okuma
Kengo Harato
Yasuo Niki
Shu Kobayashi
Takeo Nagura
Publication date
01-12-2018
Publisher
BioMed Central
Published in
Journal of Orthopaedic Surgery and Research / Issue 1/2018
Electronic ISSN: 1749-799X
DOI
https://doi.org/10.1186/s13018-018-0787-0

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