Preliminary Diagnosis: Chondrocalcinosis

I. What imaging technique is first-line for this diagnosis?

  • Plain radiographs

II. Describe the advantages and disadvantages of this technique for diagnosis of chondrocalcinosis.

Advantages

  • May be diagnostic

  • Arthropathy related to long-standing disease can be shown with peculiar patterns of structural joint damage that suggest the diagnosis

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  • Quick imaging procedure

  • Requires minimal patient cooperation

  • Low-cost procedure

  • Readily available

Disadvantages

  • Incidence of radiographically evident calcific deposits varies, as the deposits may be subtle

  • Exposure to ionizing radiation

III. What are the contraindications for the first-line imaging technique?

Contraindicated in pregnant women, especially within the first two trimesters

IV. What alternative imaging techniques are available?

  • CT scan without IV contrast

  • MR scan without IV contrast

V. Describe the advantages and disadvantages of the alternative techniques for diagnosis of chondrocalcinosis.

CT scan without IV contrast
Advantages

  • More sensitive than radiographs in the detection of articular and periarticular foci of calcification

  • Can help in the identification of additional causes of intra-articular and periarticular radiodense lesions

Disadvantages

  • Exposure to large amounts of ionizing radiation

  • More expensive than plain films

MR scan without IV contrast
Advantages

  • Sensitive in depicting articular and periarticular inflammatory changes related to the different clinical patterns of disease presentation

  • Can also identify alternative diagnosis such as osteochondritis dissecans, synovial osteochondromatosis, and intra-articular neoplasms

Disadvantages

  • Expensive

  • Time consuming

  • Requires significant patient cooperation to minimize motion artifact

VI. What are the contraindications for the alternative imaging techniques?

CT scan without IV contrast

Contraindicated in pregnant women, especially within the first two trimesters

MR scan without IV contrast

Contraindicated in patients with non-MR-compatible metallic hardware or foreign bodies

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