Pavlis W, Constantinescu DS, Murgai R, Barnhill S, Black B. Calcium pyrophosphate dihydrate crystals in a 9-year-old with osteomyelitis of the knee: A case report. World J Orthop 2022; 13(9): 870-875 [PMID: 36189334 DOI: 10.5312/wjo.v13.i9.870]
Corresponding Author of This Article
William Pavlis, Department of Orthopaedics, University of Miami, 1611 NW 12th Ave No. 303, Miami, OH 33136, United States. wwp7@med.miami.edu
Research Domain of This Article
Orthopedics
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Orthop. Sep 18, 2022; 13(9): 870-875 Published online Sep 18, 2022. doi: 10.5312/wjo.v13.i9.870
Calcium pyrophosphate dihydrate crystals in a 9-year-old with osteomyelitis of the knee: A case report
William Pavlis, David S Constantinescu, Rajan Murgai, Spencer Barnhill, Brian Black
William Pavlis, David S Constantinescu, Rajan Murgai, Spencer Barnhill, Brian Black, Department of Orthopaedics, University of Miami, Miami, 33136, United States
Author contributions: Pavlis W is responsible for the data curation and write original draft; Constantinescu D is responsible for methodology; Pavlis W, Constantinescu D, Murgai R and Barnhill S participate in the investigation; Pavlis W and Constantinescu D are responsible for the project administration; Black B is responsible for supervision; all authors participate in the manuscript conceptualization, review and editing.
Informed consent statement: The patient’s mother provided informed consent for the publication of this case report and accompanying images.
Conflict-of-interest statement: All authors report no relevant conflict of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: William Pavlis, Department of Orthopaedics, University of Miami, 1611 NW 12th Ave No. 303, Miami, OH 33136, United States. wwp7@med.miami.edu
Received: July 11, 2022 Peer-review started: July 11, 2022 First decision: August 1, 2022 Revised: August 7, 2022 Accepted: August 25, 2022 Article in press: August 25, 2022 Published online: September 18, 2022 Processing time: 66 Days and 13.4 Hours
Abstract
BACKGROUND
Calcium pyrophosphate dihydrate deposition disease (CPPD), or pseudogout, is an inflammatory arthritis common among elderly patients, but rarely seen in patients under the age of 40. In the rare cases presented of young patients with CPPD, genetic predisposition or related metabolic conditions were almost always identified.
CASE SUMMARY
The authors report the case of a 9-year-old boy with no past medical history who presented with acute knee pain and swelling after a cat scratch injury 5 d prior. Synovial fluid analysis identified calcium pyrophosphate dihydrate crystals. Further MRI analysis identified osteomyelitis and a small soft tissue abscess.
CONCLUSION
This case presents the extremely rare diagnostic finding of calcium pyrophosphate dihydrate crystals in a previously healthy pediatric patient. The presence of osteomyelitis presents a unique insight into the pathogenesis of these crystals in pediatric patients. More research needs to be done on the role of CPPD in pediatric arthritis and joint infection.
Core Tip: Calcium pyrophosphate dihydrate deposition disease (CPPD) is rarely seen in patients under the age of 40. This case represents a rare diagnostic finding of CPP crystals in a 9-year-old patient. Previously, the youngest patients ever described in case reports were 16 years old. In the rare cases presented of young patients with CPPD, genetic predisposition or related metabolic conditions were almost always identified. In this case, the presence of osteomyelitis presents a unique insight into the pathogenesis of these crystals in pediatric patients. This case highlights the need for more research on the pathogenesis of these crystals and their role in pediatric arthritis and joint infection.
