 |
|
|
 |
The Cervical Spine in Calcium Pyrophosphate Dihydrate Deposition Disease. A Prevalent
Case-Control Study
AXEL FINCKH, DANIEL VAN LINTHOUDT, BERTRAND DUVOISIN, PHILIPPE BOVAY, and JEAN-CHARLES GERSTER
ABSTRACT. Objective. To test the hypothesis that calcium pyrophosphate dihydrate (CPPD) deposition disease is a risk factor for neck pain. Methods. A prevalent case-control study was conducted to assess cervical calcifications and neck pain between patients with and without known peripheral CPPD deposition disease. CPPD cases were included if diagnosed with CPPD deposition disease of peripheral joints, and excluded if their chief complaint was neck pain. Controls were randomly selected among consecutive patients, hospitalized for conditions unrelated to CPPD deposition disease or neck pain, and matched to CPPD cases by age and sex. Cervical calcifications were assessed by lateral cervical radiographs and computed tomography scans of the upper cervical spine; neck pain and cervical function were appraised by a validated questionnaire. Results. Cervical calcifications were found in 24 out of 35 patients (69%) in the CPPD group compared to 4 out of 35 patients (11%) in the control group (p < 0.001). Patients with CPPD deposition disease reported significantly more neck pain and discomfort than controls (p < 0.001), and were 5 times more likely to report any neck pain (odds ratio 5.5; 95% confidence interval: 1.9, 21.9). Among male patients, more extensive cervical calcified deposits correlated with more severe neck pain (rs = 0.58, p = 0.03). Conclusion. These results suggest that CPPD deposition disease frequently involves the cervical spine and may be associated with the development of neck pain. (J Rheumatol 2004;31:545-9) Key Indexing Terms:
CALCIUM PYROPHOSPHATE DIHYDRATE
From the Rheumatology and Radiology Departments, University Hospital of Vaud (CHUV), Lausanne; the Rheumatology Department, Community Hospital of La Chaux-de-Fonds, Switzerland; and the Robert Brigham Arthritis and Musculoskeletal Disease Clinical Research Center, Brigham and Women's Hospital, Boston, Massachusetts, USA. Supported in part by a research grant from the Radiology Department, CHUV. Dr. Finckh is supported by a scholarship from the Swiss National Science Foundation, and partially by NIH Grant P60 AR 47782. A. Finckh, MD, CHUV, Brigham and Women's Hospital; D. Van Linthoudt, MD, Community Hospital of La Chaux-de-Fonds; B. Duvoisin, MD, CHUV; P. Bovay, MD, CHUV; J-C Gerster, MD, PhD, Professor of Rheumatology, CHUV. Address reprint requests to Dr. A. Finckh, RBB Arthritis and Musculoskeletal Clinical Research Center, Section of Clinical Sciences, Division of Rheumatology, Immunology and Allergy, Department of Medicine, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA. E-mail: afinckh@hsph.harvard.edu Submitted February 26, 2003; revision accepted September 26, 2003. |