Chondrocalcinosis, Tumoral Calcinosis, Synovial Chondromatosis, and Calcific Tendonitis

Chondrocalcinosis, or psuedogout, is the deposition of calcium pyrophosphate dehydrate crystals in the hyaline cartilage or fibrocartilage (CPPD). Pseudogout crystals are rhomboid shapted and positively birefringent. Crystals will be blue when placed under polarized light. Uric acid crystals are needle-like and negatively birefringent. Calcification of the fibrocartilage structures such as the meniscus in the knees or the Triangular Fibrocartilage Complex (TFCC) in the wrist. Chondrocalcinosis is the calcification of the cartilage (“Chondro” means cartilage, “Calcinosis” means calcification). Tumoral calcinosis is a rare condition that may be hereditary. Tumoral calcinosis occurs more often in people of African decent, as well as in females.

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Tumoral calcinosis a condition in which there is a calcium deposition which resembles a tumor. Calcium is usually deposited in the soft tissue within the periarticular area around the joint. Calcium accumulates outside the joint. This condition is usually seen in patients on dialysis. This growth does not have any malignant cells. Tumoral calcinosis is usually painless; however, swelling around the joint may limit mocement and ambulation of the patient. The calcium is usually deposited around the shoulder and the hips. A wide resection must be done in order to acoid recurrence.

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Synovial Chondromatosis is a condition which involves the synovium (intra-articular), and is usually associated with cartilaginous metaplasia. This condition usually occurs in males and in the weight-bearing joints. X-rays will show loose bodies indie of the joint. Synovial Chondromatosis is benign, noncancerous, and usually only requires symptomatic treatment unless the condition is painful. If it is painful, removal of all loose bodies is required, using an open or arthroscopic technique.

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Calcific tendonitis is the calcification of the tendon. It usually occurs within the rotator cuff tendons of the shoulder, and causes pain and inflammation. This condition occurs more often in females and diabetics. The supraspinatus tendon is most often involved. It is usually diagnosed with an x-ray, as the calcium deposits are visible on the imaging. The deposit is usually found about 1–1.5cm from the insertion of the supraspinatus tendon. An MRI will show a low signal intensity of the calcium deposit. Calcification and degeneration is usually associated with subacromal impingement.

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Dr. Ebraheim is the Chairman of Orthopaedics and the Director of the Orthopaedic Surgery Residency Program at the University of Toledo.

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