European League Against Rheumatism recommendations for calcium pyrophosphate deposition. Part I: terminology and diagnosis

被引：357

作者：

Zhang, W. ^{[1
]}

Doherty, M. ^{[1
]}

Bardin, T. ^{[2
]}

Barskova, V. ^{[3
]}

Guerne, P-A ^{[4
]}

Jansen, T. L. ^{[5
]}

Leeb, B. F. ^{[6
]}

Perez-Ruiz, F. ^{[7
]}

Pimentao, J. ^{[8
]}

Punzi, L. ^{[9
]}

Richette, P. ^{[2
]}

Sivera, F. ^{[10
]}

Uhlig, T. ^{[11
]}

Watt, I. ^{[12
]}

Pascual, E. ^{[13
]}

机构：

[1] Univ Nottingham, Nottingham NG5 1PB, England

[2] Univ Paris 07, Hop Lariboisiere, Paris, France

[3] State Inst Rheumatol, Crystal Arthrit Dept, Moscow, Russia

[4] Univ Hosp Geneva, Div Rheumatol, Geneva, Switzerland

[5] Univ Med Ctr Nijmegen St Radboud, Dept Rheumatol, Nijmegen, Netherlands

[6] Ctr Rheumatol Lower Austria, Dept Med 2, Stockerau, Austria

[7] Hosp Cruces, Secc Rheumatol, Baracaldo, Spain

[8] Egas Moniz Hosp, Dept Rheumatol, Lisbon, Portugal

[9] Univ Padua, Dept Clin & Expt Med, Rheumatol Unit, I-35100 Padua, Italy

[10] Hosp Gen Alicante, Dept Rheumatol, Alicante, Spain

[11] Diakonhjemmet Hosp, Dept Rheumatol, Oslo, Norway

[12] Univ Med Ctr, Dept Radiol, Leiden, Netherlands

[13] Hosp Gen Univ Alicante, Secc Rheumatol, Alicante, Spain

来源：

ANNALS OF THE RHEUMATIC DISEASES | 2011年 / 70卷 / 04期

关键词：

DIHYDRATE CRYSTAL DEPOSITION; INCLUDING-THERAPEUTI ESCISIT; ARTICULAR CHONDROCALCINOSIS; SYNOVIAL-FLUID; PRIMARY HYPERPARATHYROIDISM; KNEE CHONDROCALCINOSIS; TASK-FORCE; FAMILIAL CHONDROCALCINOSIS; HIP OSTEOARTHRITIS; PHOSPHATE CRYSTALS;

D O I：

10.1136/ard.2010.139105

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Objectives To agree terminology and to develop recommendations for the diagnosis of calcium pyrophosphate deposition (CPPD). Methods The European League Against Rheumatism (EULAR) CPPD Task Force, comprising 15 experts from 10 countries, agreed the terms and recommendations for diagnosis of CPPD using a Delphi consensus approach. Evidence was systematically reviewed and presented in terms of sensitivity, specificity and positive likelihood ratio (LR) to support diagnosis; ORs were used for association. Strength of recommendation (SOR) was assessed by the EULAR visual analogue scale. Results It was agreed that 'CPPD' should be the umbrella term that includes acute calcium pyrophosphate (CPP) crystal arthritis, osteoarthritis (OA) with CPPD and chronic CPP crystal inflammatory arthritis. Chondrocalcinosis (CC) defines cartilage calcification, most commonly due to CPPD and detected by imaging or histological examination. A total of 11 key recommendations were generated on the topics of clinical features, synovial fluid (SF) examination, imaging, comorbidities and risk factors. Definitive diagnosis of CPPD relies on identification of SF CPP crystals. Rapid onset inflammatory symptoms and signs are suggestive but not definitive for acute CPP crystal arthritis. Radiographic CC is not highly sensitive or specific, whereas ultrasonography appears more useful (LR=24.2, 95% CI 3.51 to 168.01) for peripheral joints. Recognised risk factors for CPPD include ageing, OA and metabolic conditions such as primary hyperparathyroidism, haemochromatosis and hypomagnesaemia; familial forms are rare. SORs varied from 53 to 99 (maximum 100). Conclusion New terms for CPPD were agreed and 11 key recommendations for diagnosis of CPPD were developed using research evidence and expert consensus.

引用

页码：563 / 570

页数：8

共 81 条

[1] The relationship between chondrocalcinosis and osteoarthritis in Saudi Arabia [J].