Images in Clinical Rheumatology
Sacroiliitis Due to Calcium Pyrophosphate Deposition Disease
Sacroilitis por pirofosfato cálcico
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Secuencia STIR, donde se observa hiperseñal en ambas articulaciones sacroilíacas; C) Tomografía computarizada, corte axial, de pelvis, donde se observa fenómeno de vacío en sacroilíaca derecha, así como calcificación interna en el fibrocartílago de ambas articulaciones sacroilíacas, con osteofitos.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Maria Jose Moreno Martinez, Manuel J. Moreno Ramos, Luis F. Linares Ferrando" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Maria Jose" "apellidos" => "Moreno Martinez" ] 1 => array:2 [ "nombre" => "Manuel J." "apellidos" => "Moreno Ramos" ] 2 => array:2 [ "nombre" => "Luis F." 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Moreno Ramos, Luis F. Linares Ferrando" "autores" => array:3 [ 0 => array:4 [ "nombre" => "Maria Jose" "apellidos" => "Moreno Martinez" "email" => array:1 [ 0 => "mjmorenomartinez@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Manuel J." "apellidos" => "Moreno Ramos" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "Luis F." "apellidos" => "Linares Ferrando" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Hospital Rafael Méndez, Lorca, Murcia, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Hospital Virgen de la Arrixaca, Murcia, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Sacroilitis por pirofosfato cálcico" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1814 "Ancho" => 1044 "Tamanyo" => 133850 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(A) Anteroposterior radiograph of pelvis showing calcification in fibrocartilage in the pubic symphysis, as well as sclerosis in both sacroiliac joints with cortical irregularity. (B) Axial slice of magnetic resonance of the pelvis. Short-tau inversion recovery (STIR) sequence, with hyperintense signal in both sacroiliac joints. (C) Computed tomography, axial image, of pelvis, showing the vacuum phenomenon in right sacroiliac joint, as well as calcification in fibrocartilage of both sacroiliac joints, with osteophytes.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We report the case of a 50-year-old woman who presented with a 3-month history of inflammatory low back pain and arthritis of the knees, with no other type of manifestations. Laboratory analyses demonstrated an elevated C-reactive protein level (2.5<span class="elsevierStyleHsp" style=""></span>mg/dL) and erythrocyte sedimentation rate (43<span class="elsevierStyleHsp" style=""></span>mm/h) and she was found to be negative for human leukocyte antigen (HLA) B27; there were no other abnormal findings. In the initial radiological study, plain radiography demonstrated meniscal calcification in both knees and sclerosis in both sacroiliac joints; magnetic resonance imaging (MRI) showed bone marrow edema in a short-tau inversion recovery (STIR) sequence (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>A and B). We observed no syndesmophytes affecting the axial skeleton. These findings led us to consider a differential diagnosis including spondyloarthritis (SpA) and pyrophosphate arthropathy. There were rectangular extracellular crystals with positive birefringence in synovial fluid obtained from knee. We requested computed tomography (CT) of the sacroiliac joints (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>C), which showed sclerosis with linear intra-articular calcifications in both joints. The patient was diagnosed with arthritis caused by calcium pyrophosphate deposition. Treatment was begun with low-dose steroids and colchicine, and the symptoms improved.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">Chondrocalcinosis develops due to calcium pyrophosphate dehydrate crystals in the fibrocartilage of the joints.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a> The joint most widely affected is the knee, although others are usually also involved. The diagnosis is based on the visualization of crystals in the synovial fluid.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Plain radiography enables the observation of calcification in the fibrocartilage and hyaline cartilage.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">In the case of diagnostic doubt, CT can be a useful aid. The images produced by MRI are little specific.<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">2–4</span></a> There are reports of cases of arthritis due to pyrophosphate involving the axial skeleton in the literature.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">5</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">The sacroiliac joint is not characteristically affected by diseases of this type. The type of pain—inflammatory and chronic in this case, together with the radiological changes, made it necessary to include SpA in the differential diagnosis. Edema in the sacroiliac joints is not always secondary to SpA.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Ethical Disclosures</span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Protection of human and animal subjects</span><p id="par0030" class="elsevierStylePara elsevierViewall">The authors declare that no experiments were performed on humans or animals for this study.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Confidentiality of data</span><p id="par0035" class="elsevierStylePara elsevierViewall">The authors declare that they have followed the protocols of their work center on the publication of patient data.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Right to privacy and informed consent</span><p id="par0040" class="elsevierStylePara elsevierViewall">The authors declare that no patient data appear in this article.</p></span></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conflict of Interest</span><p id="par0045" class="elsevierStylePara elsevierViewall">The authors declare they have no conflicts of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:3 [ 0 => array:3 [ "identificador" => "sec0005" "titulo" => "Ethical Disclosures" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0010" "titulo" => "Protection of human and animal subjects" ] 1 => array:2 [ "identificador" => "sec0015" "titulo" => "Confidentiality of data" ] 2 => array:2 [ "identificador" => "sec0020" "titulo" => "Right to privacy and informed consent" ] ] ] 1 => array:2 [ "identificador" => "sec0025" "titulo" => "Conflict of Interest" ] 2 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2016-07-15" "fechaAceptado" => "2016-11-23" "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Moreno Martinez MJ, Moreno Ramos MJ, Linares Ferrando LF. Sacroilitis por pirofosfato cálcico. Reumatol Clin. 2018;14:175–176.</p>" ] ] "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1814 "Ancho" => 1044 "Tamanyo" => 133850 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(A) Anteroposterior radiograph of pelvis showing calcification in fibrocartilage in the pubic symphysis, as well as sclerosis in both sacroiliac joints with cortical irregularity. (B) Axial slice of magnetic resonance of the pelvis. Short-tau inversion recovery (STIR) sequence, with hyperintense signal in both sacroiliac joints. (C) Computed tomography, axial image, of pelvis, showing the vacuum phenomenon in right sacroiliac joint, as well as calcification in fibrocartilage of both sacroiliac joints, with osteophytes.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:5 [ 0 => array:3 [ "identificador" => "bib0030" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Importancia de las imágenes radiológicas para el diagnóstico de la condrocalcinosis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "F. De la Guía Galipienso" 1 => "G. Vázquez Perfecto" 2 => "B.P. 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Marcelli" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Rev Rhum Engl Ed" "fecha" => "1997" "volumen" => "64" "paginaInicial" => "508" "paginaFinal" => "512" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9338935" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0045" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Magnetic resonance imaging in rheumatic disorders of the spine and sacroiliac joints" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "J.C. Oostveen" 1 => "M.A. van de Laar" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1053/sarh.2000.8368" "Revista" => array:6 [ "tituloSerie" => "Semin Arthritis Rheum" "fecha" => "2000" "volumen" => "30" "paginaInicial" => "52" "paginaFinal" => "69" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10966213" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0050" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Calcificación del ligamento transverso del atlas: síndrome de Crowned Dens" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "E. Peñas Martínez" 1 => "M.J. Moreno Martínez" 2 => "C. Marras Fernández-Cid" 3 => "B. 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 5 | 7 | 12 |
| 2024 October | 108 | 32 | 140 |
| 2024 September | 151 | 16 | 167 |
| 2024 August | 125 | 35 | 160 |
| 2024 July | 104 | 25 | 129 |
| 2024 June | 84 | 45 | 129 |
| 2024 May | 95 | 36 | 131 |
| 2024 April | 100 | 45 | 145 |
| 2024 March | 75 | 29 | 104 |
| 2024 February | 83 | 24 | 107 |
| 2024 January | 57 | 22 | 79 |
| 2023 December | 55 | 20 | 75 |
| 2023 November | 72 | 23 | 95 |
| 2023 October | 66 | 42 | 108 |
| 2023 September | 80 | 37 | 117 |
| 2023 August | 63 | 23 | 86 |
| 2023 July | 67 | 25 | 92 |
| 2023 June | 77 | 23 | 100 |
| 2023 May | 58 | 20 | 78 |
| 2023 April | 52 | 9 | 61 |
| 2023 March | 85 | 25 | 110 |
| 2023 February | 81 | 26 | 107 |
| 2023 January | 78 | 31 | 109 |
| 2022 December | 80 | 32 | 112 |
| 2022 November | 68 | 26 | 94 |
| 2022 October | 80 | 19 | 99 |
| 2022 September | 66 | 29 | 95 |
| 2022 August | 51 | 33 | 84 |
| 2022 July | 56 | 43 | 99 |
| 2022 June | 44 | 31 | 75 |
| 2022 May | 53 | 38 | 91 |
| 2022 April | 67 | 54 | 121 |
| 2022 March | 52 | 40 | 92 |
| 2022 February | 56 | 37 | 93 |
| 2022 January | 80 | 38 | 118 |
| 2021 December | 50 | 36 | 86 |
| 2021 November | 65 | 54 | 119 |
| 2021 October | 65 | 46 | 111 |
| 2021 September | 48 | 42 | 90 |
| 2021 August | 26 | 33 | 59 |
| 2021 July | 33 | 23 | 56 |
| 2021 June | 44 | 27 | 71 |
| 2021 May | 65 | 34 | 99 |
| 2021 April | 100 | 64 | 164 |
| 2021 March | 45 | 38 | 83 |
| 2021 February | 22 | 23 | 45 |
| 2021 January | 27 | 21 | 48 |
| 2020 December | 36 | 18 | 54 |
| 2020 November | 29 | 23 | 52 |
| 2020 October | 20 | 17 | 37 |
| 2020 September | 39 | 22 | 61 |
| 2020 August | 20 | 24 | 44 |
| 2020 July | 9 | 19 | 28 |
| 2020 June | 31 | 10 | 41 |
| 2020 May | 43 | 13 | 56 |
| 2020 April | 21 | 25 | 46 |
| 2020 March | 13 | 3 | 16 |
| 2020 February | 1 | 0 | 1 |
| 2019 May | 1 | 0 | 1 |
| 2018 May | 0 | 1 | 1 |
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