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Report of a Case and Review of the Literature

Kenneth H. Fye, MD; Philip R. Weinstein, MD; Fiona Donald, MD

Arch Intern Med. 1999;159:189-193.

Calcium pyrophosphate dihydrate (CPPD) deposition disease is an inflammatory arthropathy that is defined by the deposition of CPPD crystals in articular and periarticular structures. The deposition of CPPD in hyaline cartilage and fibrocartilage leads to the chondrocalcinosis that is characteristic of the disease. It can occur independently or in association with any of a number of inflammatory or endocrine disorders. This form of crystal-induced arthritis tends to affect the peripheral joints, particularly the knees, ankles, shoulders, wrists, and second and third metacarpophalangeal joints, but involvement of the lumbar spine is not uncommon. Cervical spine disease due to CPPD deposition is, however, rare. We report a case of compressive cervical myelopathy due to CPPD deposition disease of the cervical spine in a woman with long-standing rheumatoid arthritis. We also, from a review of the English-language literature, describe the collective reported clinical experience with CPPD deposition disease of the cervical spine.

From the Division of Rheumatology and Immunology (Dr Fye), Department of Medicine (Drs Fye and Donald), and Department of Neurosurgery (Dr Weinstein), University of California, and the Department of Neurosurgery, Mt Zion Medical Center (Dr Weinstein), San Francisco.

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