Posterior interosseous nerve syndrome due to pseudogout

Area of Science:

• Orthopedics
• Neurology
• Rheumatology

Background:

• Pseudogout, or calcium pyrophosphate dihydrate crystal deposition disease, commonly affects joints like the knee and wrist.
• Elbow joint involvement is less frequent, and its association with neurological complications is rarely reported.
• Posterior interosseous nerve palsy is a specific type of nerve dysfunction affecting the forearm and hand.

Observation:

• A 71-year-old woman presented with symptoms indicative of posterior interosseous nerve palsy.
• Diagnostic evaluation revealed pseudogout of the elbow joint as the underlying cause.
• This case highlights an unusual presentation of elbow pseudogout.

Findings:

• The patient's posterior interosseous nerve palsy was directly linked to the inflammatory process of elbow pseudogout.
• Conservative management, including local corticosteroid injection into the elbow joint, was initiated.
• Nonsteroidal anti-inflammatory drugs (NSAIDs) were administered systemically.

Implications:

• This case underscores the importance of considering crystal arthropathies in the differential diagnosis of nerve palsies, even in atypical locations.
• Prompt diagnosis and targeted treatment of the underlying pseudogout can lead to successful recovery of nerve function.
• Further research may elucidate the mechanisms linking joint inflammation to peripheral nerve dysfunction in pseudogout.