Calcium Pyrophosphate Dihydrate (CPPD) Crystal Deposition Disease of the Wrist

Fig. Frontal radiograph of the wrist shows calcifications of the lunotriquetral ligament (arrowhead) and triangular fibrocartilage (red arrow). Joint space narrowing with sclerosis of the trapezioscaphoid and carpometacarpal joints (yellow arrows) are noted. Note absence of osteophytes.

This patient presents with classic radiographic features of CPPD, which include:

1. Chondrocalcinosis
2. Degenerative change without apparent osteophytosis

Facts:

• At the wrist, the most common location of calcification in the area of triangular fibrocartilage is at the lunotriquetral ligament > triangular fibrocartilage > lunotriquetral cartilage.
• Degenerative change in CPPD differs from osteoarthritis in that there is less osteophyte formation.

Reference:
1. Yang B, et al. Distribution of calcification in the triangular fibrocartilage region in 181 patients with calcium pyrophosphate dihydrate crystal deposition disease. Radiology 1995; 196:547.
2. Saffar P. Chondrocalcinosis of the wrist. J Hand Surg [Br] 2004; 29:486.