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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.

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Nuffield Department of Medicine, John Radcliffe Hospital, Oxford, UK
Department of Emergency Medicine, Royal Berkshire Hospital, Reading, UK.
Department of Neuroradiology, Royal Free London NHS Foundation Trust, London, UK.
Department of Rheumatology, Royal Free London NHS Foundation Trust, London, UK.


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.


neuroimaging; radiology; rheumatology


Conflict of interest statement

Competing interests: None declared.

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