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Semin Musculoskelet Radiol 2023; 27(05): 545-552
DOI: 10.1055/s-0043-1770763
Review Article

Crystal Diseases of the Spine

Anne Cotten 
1   CHU Lille, Service de Radiologie et Imagerie Musculosquelettique, Lille, France
2   University of Lille, MABlab ULR 4490, Lille, France
,
Simon Henry
1   CHU Lille, Service de Radiologie et Imagerie Musculosquelettique, Lille, France
,
Laura Scarciolla
1   CHU Lille, Service de Radiologie et Imagerie Musculosquelettique, Lille, France
,
Ralph Abou Diwan
1   CHU Lille, Service de Radiologie et Imagerie Musculosquelettique, Lille, France
,
Xavier Demondion
1   CHU Lille, Service de Radiologie et Imagerie Musculosquelettique, Lille, France
3   University of Lille, CHU Lille, Unité de Taphonomie Médicolégale & d'Anatomie, Lille, France
,
Sammy Badr 
1   CHU Lille, Service de Radiologie et Imagerie Musculosquelettique, Lille, France
2   University of Lille, MABlab ULR 4490, Lille, France
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Abstract

Gout, calcium pyrophosphate deposition disease, and apatite calcifications, the three main crystal disorders, may involve the spine. These disorders can be completely asymptomatic or associated with various clinical symptoms, such as acute flares and more chronic manifestations. This article presents the typical and more unusual imaging features encountered in these disorders.

Keywords

apatite calcification - crystal - gout - pyrophosphate - spine


Publication History

Article published online:
10 October 2023

© 2023. Thieme. All rights reserved.

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  • References

  • 1 Adler S, Seitz M. The gouty spine: old guy—new tricks. Rheumatology (Oxford) 2017; 56 (12) 2243-2245
    CrossrefPubMedSearch in Google Scholar
  • 2 Khanna P, Johnson RJ, Marder B, LaMoreaux B, Kumar A. Systemic urate deposition: an unrecognized complication of gout?. J Clin Med 2020; 9 (10) 3204
    CrossrefPubMedSearch in Google Scholar
  • 3 Saffarzadeh M, Haydar SMA, Shojania K, Ouellette H, Nicolaou S, Murray N. Assessing tophaceous spinal gout treatment response using dual-energy CT as a point-of-care imaging modality: case report. Skeletal Radiol 2022 December 23 (Epub ahead of print)
    PubMed
  • 4 Cheng CW, Nguyen QT, Zhou H. Tophaceous gout of the cervical and thoracic spine with concomitant epidural infection. AME Case Rep 2018; 2: 35
    CrossrefPubMedSearch in Google Scholar
  • 5 Zheng ZF, Shi HL, Xing Y, Li D, Jia JY, Lin S. Thoracic cord compression due to ligamentum flavum gouty tophus: a case report and literature review. Spinal Cord 2015; 53 (12) 881-886
    CrossrefPubMedSearch in Google Scholar
  • 6 Chan AT, Leung JL, Sy AN. et al. Thoracic spinal gout mimicking metastasis. Hong Kong Med J 2009; 15 (02) 143-145
    PubMedSearch in Google Scholar
  • 7 Yip CM, Lee HP. Spinal gouty tophus presenting as an epidural mass lesion—a case report. Int J Surg Case Rep 2021; 84: 106063
    CrossrefPubMedSearch in Google Scholar
  • 8 Oaks J, Quarfordt SD, Metcalfe JK. MR features of vertebral tophaceous gout. AJR Am J Roentgenol 2006; 187 (06) W658-9
    CrossrefPubMedSearch in Google Scholar
  • 9 Martins D, Tonon CR, Pacca RL. et al. Gout storm. Am J Case Rep 2021; 22: e932683
    CrossrefPubMedSearch in Google Scholar
  • 10 Sanmillan Blasco JL, Vidal Sarro N, Marnov A, Acebes Martín JJ. Cervical cord compression due to intradiscal gouty tophus: brief report. Spine 2012; 37 (24) E1534-E1536
    CrossrefPubMedSearch in Google Scholar
  • 11 Yen HL, Cheng CH, Lin JW. Cervical myelopathy due to gouty tophi in the intervertebral disc space. Acta Neurochir (Wien) 2002; 144 (02) 205-207
    CrossrefPubMedSearch in Google Scholar
  • 12 Liu Y, Li X, Jiao G, Zhou P, Li Z. Multilevel lumbar stenosis caused by large tophi involving both spinal canal and posterior spinal elements: a rare case report and literature review. J Med Cases 2019; 10 (11) 333-337
    CrossrefPubMedSearch in Google Scholar
  • 13 Ahmad I, Tejada JG. Spinal gout: a great mimicker. A case report and literature review. Neuroradiol J 2012; 25 (05) 621-625
    CrossrefPubMedSearch in Google Scholar
  • 14 Ng W, Sin CH, Wong CH, Chiu WF, Chung OM. Unusual presentation of spinal gout: 2 case reports and literature review. J Orthop Case Rep 2017; 7 (06) 50-54
    PubMedSearch in Google Scholar
  • 15 Thuraikumar K, Wan KL, Ong KL, Lim SW. Vertebrae destruction with cauda equina syndrome secondary to spinal gouty arthritis: a case report. Malays Orthop J 2020; 14 (02) 141-144
    CrossrefPubMedSearch in Google Scholar
  • 16 Wan SA, Teh CL, Jobli AT, Cheong YK, Chin WV, Tan BB. A rare cause of back pain and radiculopathy—spinal tophi: a case report. J Med Case Rep 2019; 13 (01) 8
    CrossrefPubMedSearch in Google Scholar
  • 17 Zhou S, Xiao Y, Liu X, Zhong Y, Yang H. Gout involved the cervical disc and adjacent vertebral endplates misdiagnosed infectious spondylodiscitis on imaging: case report and literature review. BMC Musculoskelet Disord 2019; 20 (01) 425
    CrossrefPubMedSearch in Google Scholar
  • 18 Dwarki K, Dothard A, Abadie B, Miles MC. Rogue one: a story of tophaceous gout in the spine. BMJ Case Rep 2018; 2018: bcr2017221163
    CrossrefPubMedSearch in Google Scholar
  • 19 Kim T, Kim BJ, Kim SH, Lee SH. Tophaceous gout in the lumbar spinal canal mimicking epidural spinal tumor. Korean J Spine 2017; 14 (02) 50-52
    CrossrefPubMedSearch in Google Scholar
  • 20 Udayakumar D, Kteleh T, Alfata S, Bali T, Joseph A. Spinal gout mimicking paraspinal abscess: a case report. J Radiol Case Rep 2010; 4 (06) 15-20
    PubMedSearch in Google Scholar
  • 21 Manigold T, Hirschmann A, Kybur D, Daikeler T, Ankli B, Büttner F. Gouty arthritis of the atlantodental joint. Arthritis Rheumatol 2016; 68 (06) 1539
    CrossrefPubMedSearch in Google Scholar
  • 22 Romero AB, Johnson EP, Kirkpatrick JS. Tophaceous gout of the atlantoaxial joint: a case report. J Med Case Rep 2021; 15 (01) 74
    CrossrefPubMedSearch in Google Scholar
  • 23 Paquette S, Lach B, Guiot B. Lumbar radiculopathy secondary to gouty tophi in the filum terminale in a patient without systemic gout: case report. Neurosurgery 2000; 46 (04) 986-988
    PubMedSearch in Google Scholar
  • 24 Gupta SR, Cherukuri SPS, Chehab M, Paudel K, Haas C. Pseudogout of the lumbar spine. Radiol Case Rep 2023; 18 (04) 1490-1493
    CrossrefPubMedSearch in Google Scholar
  • 25 Feydy A, Lioté F, Carlier R, Chevrot A, Drapé JL. Cervical spine and crystal-associated diseases: imaging findings. Eur Radiol 2006; 16 (02) 459-468
    CrossrefPubMedSearch in Google Scholar
  • 26 Greca I, Ben Gabr J, Perl A, Bryant S, Zaccarini D. Trauma induced calcium pyrophosphate deposition disease of the lumbar spine. Case Rep Rheumatol 2020; 2020: 3218350
    PubMedSearch in Google Scholar
  • 27 Ben Tekaya A, Nacef L, Bellil M. et al. Lumbar spinal involvement in calcium pyrophosphate dihydrate disease: a systematic literature review. Int J Gen Med 2022; 15: 7639-7656
    CrossrefPubMedSearch in Google Scholar
  • 28 Namazie MR, Fosbender MR. Calcium pyrophosphate dihydrate crystal deposition of multiple lumbar facet joints: a case report. J Orthop Surg (Hong Kong) 2012; 20 (02) 254-256
    CrossrefPubMedSearch in Google Scholar
  • 29 Saylısoy S. A case of acute calcium pyrophosphate arthritis in two rare sites of involvement: the cervical facet and atlantoaxial joint. Jt Dis Relat Surg 2020; 31 (02) 395-398
    PubMedSearch in Google Scholar
  • 30 Turaga S, Thomas M, Savy L, Schreiber BE. Pseudogout or pseudolymphoma? Calcium pyrophosphate deposition disease of the cervical spine: a rare presentation and literature review. BMJ Case Rep 2019; 12 (12) e231508
    CrossrefPubMedSearch in Google Scholar
  • 31 Kobayashi T, Miyakoshi N, Abe T. et al. Acute neck pain caused by pseudogout attack of calcified cervical yellow ligament: a case report. J Med Case Rep 2016; 10 (01) 133
    CrossrefPubMedSearch in Google Scholar
  • 32 Lee J, Lee S, Bae J. Calcium pyrophosphate dihydrate crystal deposition disease involving the ligamentum flavum of the cervical spine with intense enhancement on MRI: a case report. J Korean Soc Radiol 2020; 81 (05) 1234-1238
    CrossrefPubMedSearch in Google Scholar
  • 33 Anaya JEC, Coelho SRN, Taneja AK, Cardoso FN, Skaf AY, Aihara AY. Differential diagnosis of facet joint disorders. Radiographics 2021; 41 (02) 543-558
    CrossrefPubMedSearch in Google Scholar
  • 34 Kobayashi T, Miyakoshi N, Konno N, Abe E, Ishikawa Y, Shimada Y. Acute neck pain caused by arthritis of the lateral atlantoaxial joint. Spine J 2014; 14 (09) 1909-1913
    CrossrefPubMedSearch in Google Scholar
  • 35 Yurube T, Iguchi T, Kinoshita K, Sadamitsu T, Kakutani K. Upper cervical compression myelopathy caused by the retro-odontoid pseudotumor with degenerative osteoarthritis and calcium pyrophosphate dihydrate disease: a case report and literature review. Neurospine 2021; 18 (04) 903-913
    CrossrefPubMedSearch in Google Scholar
  • 36 Haas P, Hauser TK, Kandilaris K, Skardelly M, Tatagiba M, Adib SD. Case report: posterolateral epidural supra-C2-root approach (PESCA) for biopsy of a retro-odontoid lesions in same sitting after occipitocervical fixation and decompression in a case of crowned Dens syndrome with brainstem compression and displacement. Front Surg 2022; 9: 797495
    CrossrefPubMedSearch in Google Scholar
  • 37 Chakravorty A, Murambi RT, Cherukuri RKV. Intradural calcium pyrophosphate dihydrate deposition disease: case report. J Neurosurg Spine 2021; 5: 1-4
    PubMedSearch in Google Scholar
  • 38 Gewolb DP, Entezami P, German JW, Narayan A. Rare presentation of intradural calcium pyrophosphate dihydrate crystal deposition. Neuroradiology 2021; 63 (10) 1735-1737
    CrossrefPubMedSearch in Google Scholar
  • 39 Cacciotti G, Novegno F, Fiume D. Calcium pyrophosphate dihydrate deposition disease of the filum terminale. Eur Spine J 2013; 22 (Suppl. 03) S501-S505
    CrossrefPubMedSearch in Google Scholar
  • 40 Chilloh S, Mannes I, Morelle G, Adamsbaum C. Pediatric idiopathic intervertebral disc calcification (IIDC): a challenging case. Skeletal Radiol 2021; 50 (07) 1473-1477
    CrossrefPubMedSearch in Google Scholar
  • 41 Liu J, Miao J, Niu D, Guo C, Bao X, Xu G. Pediatric idiopathic intervertebral disc calcification of the cervical spine. Chin Med J (Engl) 2022; 135 (13) 1625-1627
    CrossrefPubMedSearch in Google Scholar
  • 42 Girodias J-B, Azouz EM, Marton D. Intervertebral disk space calcification. A report of 51 children with a review of the literature. Pediatr Radiol 1991; 21 (08) 541-546
    CrossrefPubMedSearch in Google Scholar
  • 43 Du JJ, Chen YF, Peng Y, Li XJ, Ma W. Calcification of the intervertebral disc and ossification of posterior longitudinal ligament in children. BMC Musculoskelet Disord 2018; 19 (01) 316
    CrossrefPubMedSearch in Google Scholar
  • 44 Liu W, Tang C, Liu L, Zhu QS, Huang LF. Cervical intervertebral disc calcification with extreme lateral herniation in a child: T2-weighted signal intensity of the involved disc can be restored to normal. Childs Nerv Syst 2016; 32 (04) 749-752
    CrossrefPubMedSearch in Google Scholar
  • 45 Shah A, Botchu R, Grainger MF, Davies AM, James SL. Acute symptomatic calcific discitis in adults: a case report and review of literature. Skeletal Radiol 2015; 44 (12) 1819-1824
    CrossrefPubMedSearch in Google Scholar
  • 46 Lazarou I, Farracho LC, Genevay S, Iudici M. Adult-onset acute calcific discitis. J Rheumatol 2022; 49 (03) 330-331
    CrossrefPubMedSearch in Google Scholar
  • 47 Sadek AR, Dare C, McGillion S, Nader-Sepahi A, Skiadas V. Lumbar intravertebral disc herniation secondary to idiopathic calcific discitis. Br J Neurosurg 2019; 33 (05) 586-590
    CrossrefPubMedSearch in Google Scholar
  • 48 Schulze P, O'Connor C, Anand N, Wynne P. A rare cause of acute back pain in a young adult: case report and discussion of calcific discitis. J Radiol Case Rep 2020; 14 (10) 1-9
    CrossrefPubMedSearch in Google Scholar
  • 49 Gouze H, Carlier R, Breban M, Felter A. Clinical image: atypical calcification of dorsal spine. Ann Rheum Dis 2023; 26: 2023-224138
    PubMedSearch in Google Scholar
  • 50 Iampreechakul P, Lertbutsayanukul P, Suanprasert N. Acute calcific discitis or symptomatic calcified Schmorl's node of the upper thoracic spine in an adult: a case report and literature review. Asian J Neurosurg 2019; 14 (03) 1021-1029
    Thieme ConnectPubMedSearch in Google Scholar
  • 51 Xu N, Wei F, Liu X, Jiang L, Liu Z. Calcific discitis with giant thoracic disc herniations in adults. Eur Spine J 2016; 25 (Suppl. 01) 204-208
    CrossrefPubMedSearch in Google Scholar
  • 52 Urrutia J, Contreras O. Calcium hydroxyapatite crystal deposition with intraosseous penetration involving the posterior aspect of the cervical spine: a previously unreported cause of neck pain. Eur Spine J 2017; 26 (Suppl. 01) 53-57
    CrossrefPubMedSearch in Google Scholar
  • 53 Boardman J, Kanal E, Aldred P, Boonsiri J, Nworgu C, Zhang F. Frequency of acute longus colli tendinitis on CT examinations. Emerg Radiol 2017; 24 (06) 645-651
    CrossrefPubMedSearch in Google Scholar
  • 54 Matsuura H, Sugimoto Y, Sasaki E, Kiura Y, Kishida M. Acute calcific retropharyngeal tendinitis. Postgrad Med J 2019; 95 (1130): 678
    CrossrefPubMedSearch in Google Scholar
  • 55 Yamamoto N, Watari T, Kawasaki K, Matsui Y, Ozaki T. Acute calcific retropharyngeal tendinitis with eggshell-like calcification: case report and literature review on time-course changes in imaging findings. Cureus 2020; 12 (04) e7611
    PubMedSearch in Google Scholar