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BMJ Case Rep. 2019 Dec 2;12(12). pii: e231508. doi: 10.1136/bcr-2019-231508.

Pseudogout or pseudolymphoma? Calcium pyrophosphate deposition disease of the cervical spine: a rare presentation and literature review.

Author information

1
Nuffield Department of Medicine, John Radcliffe Hospital, Oxford, UK sanchit.turaga.11@ucl.ac.uk.
2
Department of Emergency Medicine, Royal Berkshire Hospital, Reading, UK.
3
Department of Neuroradiology, Royal Free London NHS Foundation Trust, London, UK.
4
Department of Rheumatology, Royal Free London NHS Foundation Trust, London, UK.

Abstract

Calcium pyrophosphate deposition (CPPD) disease is a crystal arthropathy primarily affecting peripheral joints, most commonly the wrist and the knees. However, CPPD in the cervical spine is a rare entity. This report describes a case of CPPD of the cervical spine which presents with symptoms of neck pain and brachalgia. A 62-year-old woman presented with left-sided upper limb and neck pain. MRI scanning revealed a low signal abnormality within the C6 and C7 vertebrae, and the possibility of lymphoma was raised. The patient was recalled for gadolinium-enhanced scans which showed perivertebral and marrow enhancement. Fine-needle aspirate histology initially suggested a spindle cell tumour or lymphoma. However, CT-guided biopsy showed positively birefringent crystals, confirming CPPD. CPPD of the spine is a rare differential of nerve impingement in the cervical spine when MRI scanning perivertebral signal enhancement. Furthermore, CPPD of the spine can mimic malignancy.

KEYWORDS:

neuroimaging; radiology; rheumatology

PMID:
31796457
DOI:
10.1136/bcr-2019-231508

Conflict of interest statement

Competing interests: None declared.

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