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Upper limb pyrophosphate tenosynovitis outside the carpal tunnel
1Rheumatology and Rehabilitation Centre, University Hospital, CHUV, Lausanne, Switzerland.
Annals of the Rheumatic Diseases
|August 1, 1989
Summary
Calcium pyrophosphate dihydrate (CPPD) crystal deposits can occur in tendon sheaths outside the carpal tunnel. Surgical intervention was necessary for two patients with these rare crystal accumulations.
Area of Science:
- Rheumatology
- Orthopedics
- Crystal Arthropathies
Background:
- Calcium pyrophosphate dihydrate (CPPD) crystal deposition disease typically affects joints.
- Tendinous involvement outside the carpal tunnel is less commonly reported.
Observation:
- Three cases of CPPD crystal deposits within tendon sheaths, distinct from the carpal tunnel, are presented.
- Diagnostic methods included X-ray diffraction and compensated light microscopy.
- Two patients required surgical excision of the affected tendon synovial sheath.
Findings:
- Confirmation of CPPD crystals in tendon sheaths using specific analytical techniques.
- Demonstration of a potential extra-articular manifestation of CPPD disease.
- Surgical intervention was effective in managing symptomatic cases.
Implications:
- Highlights the importance of considering CPPD crystal deposits in differential diagnoses for tendinopathies.
- Suggests that tendon sheaths may be a site for CPPD crystal accumulation.
- Underscores the need for thorough diagnostic evaluation in atypical presentations of crystal arthropathies.