Distribution of calcification in the triangular fibrocartilage region in 181 patients with calcium pyrophosphate dihydrate crystal deposition disease.

Abstract

To investigate the occurrence of calcification around the triangular fibrocartilage complex in calcium pyrophosphate dihydrate (CPPD) crystal deposition disease. The radiographs of 316 wrists in 181 patients with a definite or probable diagnosis of CPPD disease were reviewed to determine the occurrence of calcification in the inferior radioulnar joint cartilage, triangular fibrocartilage, lunotriquetral ligament, lunotriquetral cartilage, and triquetral cartilage. The distribution of calcification in the 316 wrists was as follows: inferior radioulnar joint cartilage, 87 wrists (28%), triangular fibrocartilage, 233 (74%); lunotriquetral ligament, 244 (77%); lunotriquetral cartilage, 167 (53%); and triquetral cartilage, 66 (21%). Forty-nine wrists had calcification in the lunotriquetral ligament or cartilage but not in the triangular fibrocartilage; 30 wrists had calcification in the triangular fibrocartilage but not in the lunotriquetral ligament or cartilage. This difference in prevalence was statistically significant (P = .0429). Radiologic diagnosis of CPPD crystal deposition disease in the wrist necessitates careful evaluation of the lunotriquetral ligament as well as the triangular fibrocartilage.