Chondrocalcinosis Diagnosis and Management

Diagnostic Implications

Chondrocalcinosis is the radiographic hallmark of CPPD disease (pseudogout), appearing as calcification of fibrocartilage (menisci) and hyaline cartilage in the knee, according to the American College of Radiology 1, 2, 3
Radiography should be the initial imaging method when pseudogout is suspected, as it effectively demonstrates characteristic calcifications and disease distribution, as recommended by the American College of Radiology 1, 2, 3

Plain radiographs are the appropriate initial imaging method and should include anteroposterior, lateral, and tangential patellar views to fully evaluate for chondrocalcinosis and associated arthropathy, according to the American College of Radiology 1, 2, 3
The American College of Radiology recommends ultrasound can detect chondrocalcinosis and may occasionally identify it when evaluating for other pathology 4, 5
Ultrasound outperforms radiography for chondrocalcinosis detection, and can demonstrate echogenic synovial hypertrophy and the "double contour sign" 1, 2, 3
CT can identify chondrocalcinosis and calcification of tendons, ligaments, and joint capsules, with informativity nearly equal to conventional radiography 1, 2, 3
MRI without contrast may be indicated when symptoms persist despite radiographic findings, to evaluate for synovitis, bone marrow lesions, or other soft tissue pathology not explained by chondrocalcinosis alone 4, 5

Joint aspiration with synovial fluid analysis is indicated when effusion is present to confirm crystal disease or exclude infection, and can be performed under ultrasound or fluoroscopic guidance, as recommended by the American College of Radiology 4, 5