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Case report
Pseudogout or pseudolymphoma? Calcium pyrophosphate deposition disease of the cervical spine: a rare presentation and literature review
  1. Sanchit Turaga1,
  2. Michael Thomas2,
  3. Lloyd Savy3 and
  4. Benjamin E Schreiber4
  1. 1Nuffield Department of Medicine, John Radcliffe Hospital, Oxford, UK
  2. 2Department of Emergency Medicine, Royal Berkshire Hospital, Reading, UK
  3. 3Department of Neuroradiology, Royal Free London NHS Foundation Trust, London, UK
  4. 4Department of Rheumatology, Royal Free London NHS Foundation Trust, London, UK
  1. Correspondence to Dr Sanchit Turaga; sanchit.turaga.11{at}ucl.ac.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.

  • neuroimaging
  • radiology
  • rheumatology
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Footnotes

  • Contributors ST: wrote and edited the paper. MT: reviewed and edited the paper. LS: edited the paper, provided images. BS: edited and oversaw the overall manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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