Turkish Journal of Physical Medicine and Rehabilitation 2007 , Vol 53 , Num 4

Calcium Pyrophosphate Arthropathy Beginning with Avascular Necrosis of Scaphoid Bone After Trauma: A Case Report

Zerrin Şahin 1 ,Aslıhan Taraktaş 2 ,Cengiz Bahadır 2 ,Sena Topatan 3
1 Haydarpaşa Numune Eğitim ve Araştırma Hastanesi, Fizik Tedavi ve Rehabilitasyon Kliniği, İstanbul
2 Haydarpaşa Numune Eğitim ve Araştırma Hastanesi, Fiziksel Tıp ve Rehabilitasyon Kliniği, İstanbul
3 Haydarpasa Numune Training and Research Hospital, Physical Medicine and Rehabilitation Clinic, Istanbul, Turkey

The deposition of intra-articular calcium pyrophosphate dehydrate (CPPD) crystals occurs most commonly in older individuals and it is usually asymptomatic. However it may begin with clinical findings similar to acute gout, osteoarthritis, rheumatoid arthritis, and neuropathic arhritis. The cause of CPPD crystal deposition is uncertain. The joints most frequently effected are the triangular fibrocartilage of the wrist, elbow, hip, symphsis pubis, and meniscus and hyaline cartilage of the knee. Avascular necrosis can occur in bone areas with terminal circulation when the blood supply is disrupted. Commonly involved bones include the femoral head, talus, and scaphoid. Avascular necrosis of the carpal scaphoid bone can occur after a fracture, repetitive trauma or accompany with a systemic disease and chronic steroid intake. In this report, a case with avascular necrosis of the carpal scaphoid bone after trauma and CPPD deposition in paraarticular soft tissues has been evaluated in the light of relevant literature. 

Keywords : Avascular necrosis, calcium pyrophosphate arthropathy, trauma