DISTRIBUTION OF CALCIFICATION IN THE TRIANGULAR FIBROCARTILAGE REGIONIN 181 PATIENTS WITH CALCIUM PYROPHOSPHATE DIHYDRATE CRYSTAL DEPOSITION DISEASE

PURPOSE: To investigate the occurrence of calcification around the tri angular fibrocartilage complex in calcium pyrophosphate dihydrate (CPP D) crystal deposition disease. MATERIALS AND METHODS: The radiographs of 316 wrists in 181 patients with a definite or probable diagnosis of CPPD disease were reviewed to determine the occurrence of calcificati on in the inferior radioulnar joint cartilage, triangular fibrocartila ge, lunotriquetral ligament, lunotriquetral cartilage, and triquetral cartilage. RESULTS: The distribution of calcification in the 316 wrist s was as follows: inferior radioulnar joint cartilage, 87 wrists (28%) ; triangular fibrocartilage, 233 (74%); lunotriquetral ligament, 244 ( 77%); lunotriquetral cartilage, 167 (53%); and triquetral cartilage, 6 6 (21%). Forty-nine wrists had calcification in the lunotriquetral lig ament or cartilage but not in the triangular fibrocartilage; 30 wrists had calcification in the triangular fibrocartilage but not in the lun otriquetral ligament or cartilage. This difference in prevalence was s tatistically significant (P =.0429). CONCLUSION: Radiologic diagnosis of CPPD crystal deposition disease in the wrist necessitates careful e valuation of the lunotriquetral ligament as well as the triangular fib rocartilage.