Calcium pyrophosphate dihydrate crystal deposition disease of the wrist: Trapezioscaphoid joint abnormality

Objective. To determine whether trapezioscaphoid (TS) joint alterations are associated with calcium pyrophosphate dihydrate (CPPD) crystal deposition disease and, if so, to determine the nature of these alterations. Methods. Radiographs of 160 wrists with evidence of chondrocalcinosis were evaluated with regard to TS joint abnormalities, and findings were compared with a similar number of radiographs in an age and sex matched control pop ulation in whom no evidence of chondrocalcinosis or other calcification in the wrist was seen. Two radiologists in consensus recorded radiographic fin dings in both groups, and a third radiologist blinded to the presence or ab sence of chondracalcinosis reviewed wrist radiographs in both groups in a r andom order. Correlation of TS joint abnormalities with other changes in th e wrist was also accomplished. Results. TS arthropathy was found in 43.7% of CPPD wrists and in 14.4% of c ontrol wrists in the consensus evaluation. In the blind evaluation, 30% of CPPD wrists and 12.5% of control wrists had TS arthropathy. The degree of a rthropathy was more extensive in the CPPD group than in the control group. Features associated with TS arthropathy in the patient population were firs t carpometacarpal arthropathy and subchondral cysts in the scaphoid or trap ezium, or both bones. Conclusion. CPPD patients, compared to a control population, reveal frequen t and significant radiographic abnormalities of the TS joint that may be su ggestive of the diagnosis, even in patients in whom chondrocalcinosis is ob scured or absent. The features associated with TS arthropathy are first car pometacarpal arthropathy and subchondral cysts in the scaphoid and trapeziu m.