Is ultrasonography or radiography more sensitive in the detection of calcium pyrophosphate crystal deposition (CPPD)?

Updated: Jan 26, 2021
  • Author: Bruce M Rothschild, MD; Chief Editor: Herbert S Diamond, MD  more...
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Answer

Ultrasonography had higher sensitivity than radiography for detection of calcium pyrophosphate crystal deposition (CPPD) in a study by Ottaviani et al. In 51 patients, ultrasonography revealed hyperechoic spots in all 25 patients with CPPD (sensitivity 100%, specificity 92.3%), whereas radiography revealed CPPD in 16 of the 25 (sensitivity 64%, specificity 100%; P < 0.0001). [111]

In a study by Forien et al that included 32 patients with CPPD and 26 controls, the sensitivity of wrist ultrasonography for the diagnosis of CPPD was 94% while that of wrist radiography was 53.1%; the specificity of ultrasonography was 85%, versus 100% for radiography. [112] Ultrasonography revealed chondrocalcinosis in 35 joints with no radiographic evidence of chondrocalcinosis, and x-rays showed chondrocalcinosis in 3 joints without ultrasonographic chondrocalcinosis, thus indicating the complementary benefit of utilizing both techniques.


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