Tissue changes detectable by sonography before radiological evidence of elbow chondrocalcinosis

Chondrocalcinosis is a joint disease caused by deposits of calcium pyrophosphate dihydrate (CPPD) crystals with manifestations that may include intermittent attacks of acute arthritis or enthesitis. If no crystals are found on synovial analysis, the diagnosis in clinical practice is based on typical radiographic findings, although it is now recognized that some signs of the disease could also be seen by ultrasound. We studied six patients with elbow enthesopathy without radiographic evidence of CPPD that presented ultrasound findings suggesting joint calcification. On the basis of these echographic findings, the diagnosis was then ascertained by x-ray examination of the most commonly involved joints. Ultrasound is a method of proven interest in the evaluation of rheumatic patients and could be an important tool in diagnosing CPPD.