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Recurrent back pain and fevers.

Christina R Cameron1, Carl D Burgess

  • 1Department of Medicine, Wellington Hospital, Wellington, New Zealand. chris.cameron@cdhb.govt.nz

The Medical Journal of Australia
|February 21, 2007
PubMed
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Systemic calcium pyrophosphate deposition disease (CPPD) can cause spinal issues like intermittent cauda equina syndrome. Differentiating CPPD from spinal infections presents a significant clinical challenge.

Area of Science:

  • Rheumatology
  • Neurology
  • Orthopedics

Background:

  • Systemic calcium pyrophosphate deposition disease (CPPD) is a crystal-induced arthropathy.
  • Spinal involvement in CPPD can mimic infectious or neoplastic processes.
  • Accurate diagnosis is crucial for appropriate management and preventing complications.

Observation:

  • An elderly woman presented with recurrent back pain, fever, and neurological deficits.
  • She developed pseudogout of the knee, leading to a diagnosis of systemic CPPD.
  • The CPPD involved the spine, causing intermittent cauda equina syndrome.

Findings:

  • Systemic CPPD can manifest with spinal symptoms, including neurological deficits.
  • Intermittent cauda equina syndrome was a presenting feature of spinal CPPD in this case.

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  • The clinical presentation of spinal CPPD can be challenging to distinguish from spinal infections.

    • Implications:

    • This case highlights the importance of considering CPPD in elderly patients with spinal symptoms and fever.
    • Clinicians must be aware of the potential for CPPD to mimic spinal infections.
    • Early recognition and differentiation are key to effective treatment of spinal CPPD.