mrjСовременная ревматологияModern Rheumatology Journal1996-70122310-158XIMA-PRESS, LLC10.14412/1996-7012-2010-595mrj-280Research ArticleСтатьиArticlesПирофосфатная артропатия - ревматологический синдром «айсберга»: время для переоценки значения в патологии суставовPYROPHOSPHATE ARTHROPATHY IS A RHEUMATOLOGICAL ICEBERG SYNDROME: TIME TO REASSESS ITS IMPORTANCE IN JOINT DISEASESБарсковаВ. Г.BarskovaViktoria Georgiyevnabarskova@irramn.ru <mailto:barskova@irramn.ru>IlyinaA EIlyinaA E-СеменоваЛ. А.SemenovaL A-Radenska-LopovokS GRadenska-LopovokS G-OsipyantsM AOsipyantsM A-СмирновА. В.SmirnovA V-МакаровМ. А.MakarovM A-20102006201042№2 (2010)511Copyright © Барскова В.Г., Ilyina A.E., Семенова Л.А., Radenska-Lopovok S.G., Osipyants M.A., Смирнов А.В., Макаров М.А., 20102010Барскова В.Г., Ilyina A.E., Семенова Л.А., Radenska-Lopovok S.G., Osipyants M.A., Смирнов А.В., Макаров М.А.Barskova V.G., Ilyina A.E., Semenova L.A., Radenska-Lopovok S.G., Osipyants M.A., Smirnov A.V., Makarov M.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://mrj.ima-press.net/mrj/article/view/280

В статье изложены современные представления об эпидемиологии, патогенезе, диагностике, классификации пирофосфатной артропатии (ПФА). Приведено описание морфологического исследования структуры коленного сустава после тотального протезирования у пациента с диагнозом «остеоартроз». Рассмотрены причины низкой выявляемости заболевания. Детально проанализированы сложности лабораторной и инструментальной диагностики ПФА

The paper provides the present views of the epidemiology, pathogenesis, diagnosis, and classification of pyrophosphate arthropathy (PPA). It describes a morphological study of the structure of the knee joint after total prosthetics in a patient diagnosed as having osteoarthrosis. Reasons for low detection rates of the disease are considered. Difficulties in the laboratory and instrumental diagnosis of PPA are analyzed in detail.

пирофосфатная артропатиякристаллы пирофосфата кальцияхондрокальцинозpyrophosphate arthropathycalcium pyrophosphate crystalschondrocalcinosisReferences<div><p>Rutsch F., Terkeltaub R. Parallels between arterial and cartilage calcification: what understanding artery calcification can teach us about chondrocalcinosis. Curr Opin Rheum 2003; 15: 302-10.</p><p>Doherty M. Calcium pyrophosphate dihydrate crystal-associated arthropathy. In: Hochberg M., ed. Rheumatology. Edinburgh: Mosby, 2003; 1937-50.</p><p>McCarty D.J. Pseudogout, articular chondrocalcinosis. In: Hollander J.L., ed. Arthritis and Allied Conditions. Edition 7. Philadelphia: Lea &amp; Febiger, 1966; 947-63.</p><p>Pasquetti P., Selvi E., Righeschi K. et al. Joint lavage and pseudogout. Ann Rheum Dis 2004; 63: 1529-30.</p><p>Ivorra J., Rosas J., Pascual E. Most calcium pyrophosphate crystals appear as non- birefringent. Ann Rheum Dis 1999; 58: 582-4.</p><p>Martinez Sanchis A., Pascual E. Intracellular and extracellular CPPD crystals are a regular feature in synovial fluid from uninflamed joints of patients with CPPD related arthropathy. Ann Rheum Dis 2005; 64: 1769-72.</p><p>Gordon С., Swan А., Dieppe Р. Detection of crystals in synovial fluids by light microscopy: sensitivity and reliability. Ann Rheum Dis 1989; 48: 737-42.</p><p>Lane L. Request centrifuging of synovial fluid for accurate gout diagnosis. Rev Prat ; 44(2): 197-200.</p><p>Abreu M., Johnson K., Chung C.B. et al. Calcification in calcium pyrophosphate dihydrate (CPPD) crystalline deposits in the knee: anatomic, radiographic, MR imaging, and histologic study in cadavers. Skeletal Radiol 2004; 33: 392-8.</p><p>Filippucci E., Gutierrez Riveros M., Georgescu D. et al. Hyaline cartilage involvement in patients with gout and calcium pyrophosphate deposition disease. An ultrasound study. Osteoarthr Cart 2009; 17: 178-81.</p><p>Frediani B., Flippou G., Falsetti P. et al. Diagnosis of calcium pyrophosphate dihydrate crystal deposition disease: ultrasonographic criteria proposed. Ann Rheum Dis 2005; 64: 638-40.</p><p>Flippou G., Frediani B., Gallo A. et al. A «new» technique for the diagnosis of chondrocalcinosis of the knee: sensitivity and specificity of high-frequency ultrasonography. Ann Rheum Dis 2007; 66: 1126-8.</p><p>Falsetti P., Frediani B., Acciai C. et al. Ultrasonographic study of Achilles tendon and plantar fascia in chondrocalcinosis. J Rheumatol 2004; 31: 2242-50.</p><p>Richette P., Bardin T., Doherty M. An update on the epidemiology of calcium pyrophosphate dihydrate crystal deposition disease. Rheumatology 2009; 48(7): 711-5.</p><p>Neame R.L., Carr A.J., Muir K. et al. UK community prevalence of knee chondrocalcinosis: evidence that correlation with osteoarthritis is through a shared association with osteophyte. Ann Rheum Dis 2003; 62: 513-8.</p><p>Felson D.T., Anderson J.J., Naimark A. et al. The prevalence of chondrocalcinosis in the elderly and its association with knee osteoarthritis: the Framingham Study. J Rheumatol 1989; 16: 1241-5.</p><p>Sanmarti R., Panella D., Brancos M.A. et al. Prevalence of articular chondrocalcinosis in elderly subjects in a rural area of Catalonia. Ann Rheum Dis 1993; 52: 418-22.</p><p>Saadeh C. Calcium Pyrophosphate Deposition Disease. Medscape, 09.2009.</p><p>Derfus B.A., Kurian J.B., Butler J.J. et al. The high prevalence of pathologic calcium crystals in pre-operative knees. J Rheumatol 2002; 29; 570-4.</p><p>Nalbant S., Martinez J.A., Kitumnuaypong T. et al. Synovial fluid features and their relations to osteoarthritis severity: new findings from sequential studies. Osteoarthritis Cartilage 2003; 11: 50-4.</p><p>Viriyavejkul P., Wilairatana V., Tanavalee A. et al. Comparison of characteristics of patients with and without calcium pyrophosphate dihydrate crystal deposition disease who underwent total knee replacement surgery for ostheoarthritis. Osteoarthr Cart 2007; 15: 232-5.</p><p>Mitseyama H., Healay R.M., Terkeltaub R.A. et al. Calcification of human articular knee cartilage is primarily an effect of aging rather than osteoarthritis. Osteoarthr Cart 2007; 15: 559-65.</p><p>Muehieman O., Li J., Aigner T. et al. Association between crystals and cartilage degeneration in the ankle. J Rheumatol 2008; 35: 1108-17.</p></div><br /><div><p>Rutsch F., Terkeltaub R. Parallels between arterial and cartilage calcification: what understanding artery calcification can teach us about chondrocalcinosis. Curr Opin Rheum 2003; 15: 302-10.</p><p>Doherty M. Calcium pyrophosphate dihydrate crystal-associated arthropathy. In: Hochberg M., ed. Rheumatology. Edinburgh: Mosby, 2003; 1937-50.</p><p>McCarty D.J. Pseudogout, articular chondrocalcinosis. In: Hollander J.L., ed. Arthritis and Allied Conditions. Edition 7. Philadelphia: Lea &amp; Febiger, 1966; 947-63.</p><p>Pasquetti P., Selvi E., Righeschi K. et al. Joint lavage and pseudogout. Ann Rheum Dis 2004; 63: 1529-30.</p><p>Ivorra J., Rosas J., Pascual E. Most calcium pyrophosphate crystals appear as non- birefringent. Ann Rheum Dis 1999; 58: 582-4.</p><p>Martinez Sanchis A., Pascual E. Intracellular and extracellular CPPD crystals are a regular feature in synovial fluid from uninflamed joints of patients with CPPD related arthropathy. Ann Rheum Dis 2005; 64: 1769-72.</p><p>Gordon С., Swan А., Dieppe Р. Detection of crystals in synovial fluids by light microscopy: sensitivity and reliability. Ann Rheum Dis 1989; 48: 737-42.</p><p>Lane L. Request centrifuging of synovial fluid for accurate gout diagnosis. Rev Prat ; 44(2): 197-200.</p><p>Abreu M., Johnson K., Chung C.B. et al. Calcification in calcium pyrophosphate dihydrate (CPPD) crystalline deposits in the knee: anatomic, radiographic, MR imaging, and histologic study in cadavers. Skeletal Radiol 2004; 33: 392-8.</p><p>Filippucci E., Gutierrez Riveros M., Georgescu D. et al. Hyaline cartilage involvement in patients with gout and calcium pyrophosphate deposition disease. An ultrasound study. Osteoarthr Cart 2009; 17: 178-81.</p><p>Frediani B., Flippou G., Falsetti P. et al. Diagnosis of calcium pyrophosphate dihydrate crystal deposition disease: ultrasonographic criteria proposed. Ann Rheum Dis 2005; 64: 638-40.</p><p>Flippou G., Frediani B., Gallo A. et al. A «new» technique for the diagnosis of chondrocalcinosis of the knee: sensitivity and specificity of high-frequency ultrasonography. Ann Rheum Dis 2007; 66: 1126-8.</p><p>Falsetti P., Frediani B., Acciai C. et al. Ultrasonographic study of Achilles tendon and plantar fascia in chondrocalcinosis. J Rheumatol 2004; 31: 2242-50.</p><p>Richette P., Bardin T., Doherty M. An update on the epidemiology of calcium pyrophosphate dihydrate crystal deposition disease. Rheumatology 2009; 48(7): 711-5.</p><p>Neame R.L., Carr A.J., Muir K. et al. UK community prevalence of knee chondrocalcinosis: evidence that correlation with osteoarthritis is through a shared association with osteophyte. Ann Rheum Dis 2003; 62: 513-8.</p><p>Felson D.T., Anderson J.J., Naimark A. et al. The prevalence of chondrocalcinosis in the elderly and its association with knee osteoarthritis: the Framingham Study. J Rheumatol 1989; 16: 1241-5.</p><p>Sanmarti R., Panella D., Brancos M.A. et al. Prevalence of articular chondrocalcinosis in elderly subjects in a rural area of Catalonia. Ann Rheum Dis 1993; 52: 418-22.</p><p>Saadeh C. Calcium Pyrophosphate Deposition Disease. Medscape, 09.2009.</p><p>Derfus B.A., Kurian J.B., Butler J.J. et al. The high prevalence of pathologic calcium crystals in pre-operative knees. J Rheumatol 2002; 29; 570-4.</p><p>Nalbant S., Martinez J.A., Kitumnuaypong T. et al. Synovial fluid features and their relations to osteoarthritis severity: new findings from sequential studies. Osteoarthritis Cartilage 2003; 11: 50-4.</p><p>Viriyavejkul P., Wilairatana V., Tanavalee A. et al. Comparison of characteristics of patients with and without calcium pyrophosphate dihydrate crystal deposition disease who underwent total knee replacement surgery for ostheoarthritis. Osteoarthr Cart 2007; 15: 232-5.</p><p>Mitseyama H., Healay R.M., Terkeltaub R.A. et al. Calcification of human articular knee cartilage is primarily an effect of aging rather than osteoarthritis. Osteoarthr Cart 2007; 15: 559-65.</p><p>Muehieman O., Li J., Aigner T. et al. Association between crystals and cartilage degeneration in the ankle. J Rheumatol 2008; 35: 1108-17.</p></div><br />

The authors declare that there are no conflicts of interest present.