Do Not Hallow until You Are out of the Wood! Ultrasonographic Detection of CPP Crystal Deposits in Menisci: Facts and Pitfalls

Purpose. Ultrasonography (US) has been demonstrated to be an important tool in the diagnosis of calcium pyrophosphate (CPP) crystal deposition disease. The aim of our study was to individuate and describe possible pitfalls in US detection of such deposits in menisci. Patients and Methods. We enrolled all patients waiting to undergo knee replacement surgery due to osteoarthritis, for one-month period. Each patient underwent US examination of the knee, focusing on the menisci. After surgery, the menisci were examined by US, macroscopically and microscopically, using the microscopic analysis as the gold standard for CPP deposition. Results. 11 menisci of 6 patients have been studied. Ex vivo examination of menisci performed better in CPP identification than in vivo examination. The possible reasons of misinterpretation or misdiagnosis of the in vivo exam were identified and are extensively described in the paper. Also a new sign of CPP crystal deposits was found. Conclusions. This study permitted to highlight some difficulties in CPP crystal detection by US in menisci. Further studies are needed to define completely US CPP crystal aspect and to improve the sensibility and specificity of US in CPP deposition diagnosis

Long-term effects of neridronate on human osteoblastic cell cultures

Bisphosphonates (BP's) are widely used in the treatment of a variety of bone-related diseases, particularly where the bone turnover is skewed in favor of osteolysis. The mechanisms by which BP's reduce bone resorption directly acting oil osteoclasts are now largely clarified even at molecular level. Researches concerning the BP's effects on osteoblast have instead shown variable results. Many in vitro studies have reported positive effects on osteoblasts proliferation and mineralization for several BPs, however, the observed effects differ, depending on the variety of different model system that has been used. Objectives. We have investigated if neridronate, an aminobisphosphonate suitable for pulsatory parenteral administration, could have an effect on human osteoblastic proliferation and differentiation in vitro. Methods. We have investigated whether prolonged addition of neridronate (from 10(-3) to 10(-11) M) to different human osteoblasts cultures, obtained from 14 different bone specimens, could affect the cells number, the endogenous cellular alkaline phosphatase (ALKP) activity, and the formation of mineralized nodules. Results. Our results show that neridronate does not negatively affect in vitro the viability, proliferation, and cellular activity of normal human osteoblasts even after a long period addition of the drug (20 days) at concentrations equal or lower than 10(-5) mol/l (therapeutic dose). In addition, neridronate seems to enhance the differentiation of cultured osteoblasts in mature bone-forming cells. A maximum increase of alkaline phosphatase activity (+50% after 10 days; P < 0.01) and mineralized nodules (+48% after 20 days; P < 0.05) was observed in cultures treated with neridronate 10(-8) M. Conclusions. These results encourage the use of neridronate in long-term therapy of demineralizing metabolic bone disorders

Criterion validity of ultrasound in the identification of calcium pyrophosphate crystal deposits at the knee: an OMERACT ultrasound study

none40siTo evaluate the discriminatory ability of ultrasound in calcium pyrophosphate deposition disease (CPPD), using microscopic analysis of menisci and knee hyaline cartilage (HC) as reference standard.Filippou, Georgios; Scanu, Anna; Adinolfi, Antonella; Toscano, Carmela; Gambera, Dario; Largo, Raquel; Naredo, Esperanza; Calvo, Emilio; Herrero-Beaumont, Gabriel; Zufferey, Pascal; Bonjour, Christel Madelaine; MacCarter, Daryl K; Makman, Stanley; Weber, Zachary; Figus, Fabiana; Möller, Ingrid; Gutierrez, Marwin; Pineda, Carlos; Clavijo Cornejo, Denise; Garcia, Hector; Ilizaliturri, Victor; Mendoza Torres, Jaime; Pichardo, Raul; Rodriguez Delgado, Luis Carlos; Filippucci, Emilio; Cipolletta, Edoardo; Serban, Teodora; Cirstoiu, Catalin; Vreju, Florentin Ananu; Grecu, Dan; Mouterde, Gaël; Govoni, Marcello; Punzi, Leonardo; Damjanov, Nemanja S; Keen, Helen Isobel; Bruyn, George Aw; Terslev, Lene; D'Agostino, Maria-Antonietta; Scirè, Carlo Alberto; Iagnocco, AnnamariaFilippou, Georgios; Scanu, Anna; Adinolfi, Antonella; Toscano, Carmela; Gambera, Dario; Largo, Raquel; Naredo, Esperanza; Calvo, Emilio; Herrero-Beaumont, Gabriel; Zufferey, Pascal; Bonjour, Christel Madelaine; Maccarter, Daryl K; Makman, Stanley; Weber, Zachary; Figus, Fabiana; Möller, Ingrid; Gutierrez, Marwin; Pineda, Carlos; Clavijo Cornejo, Denise; Garcia, Hector; Ilizaliturri, Victor; Mendoza Torres, Jaime; Pichardo, Raul; Rodriguez Delgado, Luis Carlos; Filippucci, Emilio; Cipolletta, Edoardo; Serban, Teodora; Cirstoiu, Catalin; Vreju, Florentin Ananu; Grecu, Dan; Mouterde, Gaël; Govoni, Marcello; Punzi, Leonardo; Damjanov, Nemanja S; Keen, Helen Isobel; Bruyn, George Aw; Terslev, Lene; D'Agostino, Maria-Antonietta; Scirè, Carlo Alberto; Iagnocco, Annamari