Chondrocalcinosis in large joint osteoarthritis (OA) was not associated with a unifying radiographic phenotype, according to research published in Arthritis Care & Research.   An association was also found between distal joint chondrocalcinosis and knee bone attrition in OA, which may be related to increased level of synovial fluid pyrophosphate that results in less osteophytosis resulting in bone attrition.

To investigate whether chondrocalcinosis was associated with a distinct radiographic phenotype of OA in the knees or hips, Abhishek Abhishek, MBBS, MD, PhD, from the University of Nottingham and colleagues conducted a case-control study using data from 3170 participants in the Genetics of Osteoarthritis and Lifestyle (GOAL) study. All participants underwent radiographs of the knees, hands, and pelvis that the researchers scored for chondrocalcinosis and individual diagnostic radiographic features of OA.

Researchers found that knee chondrocalcinosis and chondrocalcinosis at distal joints were associated with significant bone attrition in knee OA, and that hip chondrocalcinosis was associated with a milder hip OA phenotype. They also found no evidence that chondrocalcinosis was associated with hypertrophic OA.


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The researchers found that:

  • In knee OA, knee chondrocalcinosis and chondrocalcinosis at any distal joint (without knee chondrocalcinosis) were associated with attrition (adjusted odds ratio 2.32 [95% confidence interval (CI), 1.42-3.79] and 2.42 [95% CI, 1.41-4.13], respectively).
  • In knee OA, there was no association between knee chondrocalcinosis and osteophytosis or joint space narrowing.
  • In hip OA, hip chondrocalcinosis was associated negatively with the summated osteophyte score and minimum joint space narrowing.
  • In hip OA, chondrocalcinosis was not associated with cysts or sclerosis.
  • In hip OA, distal joint chondrocalcinosis was not associated with any change in hip OA.

“The findings of this study suggest that the presence of florid osteophytosis should not be used to speculate on whether calcium pyrophosphate crystal deposition (CPPD), the [most common] cause of chondrocalcinosis, could be present or not,” the authors wrote.

Summary and Clinical Applicability

Researchers found no unifying radiographic structural arthropathy in joints with OA and CC. Specifically, knee chondrocalcinosis and chondrocalcinosis at distal joints were associated with bone attrition in knee OA, and that hip chondrocalcinosis was associated with a milder hip OA phenotype. They found no evidence that chondrocalcinosis was associated with hypertrophic OA.

The findings of this study suggest that the presence of florid osteophytosis should not be used to speculate on whether CPPD could be present or not.

This study was limited to patients with end-stage OA, and as such generalizability would be limited to this specific patient population. The authors note, “it is desirable for these findings to be confirmed in a community-based study using ultrasound examination or synovial fluid analysis, both of which have a greater sensitivity for detecting CPPD.”

Reference

Abhishek A, Doherty S, Maciewicz RA, Muir K, Zhang W, Doherty M. Does chondrocalcinosis associate with a distinct radiographic phenotype of osteoarthritis in knees and hips? A case-control study. Arthritis Care Res. 2016;68(2):211-216. doi:10.1002/acr.22652.