Case 12
History:
56 year old female with chronic knee pain
Findings:
Plain radiography of the knees showed degenerative changes affecting the medial compartment of the knee and calcification of the menisci. The lateral view showed calcification within the origin of the medial head of gastrocnemius.
Diagnosis:
Gastrocnemius tendon calcification associated with chondrocalcinosis of the knee
Discussion:
Calcification in tendons is relatively common in CPPD crystal deposition, especially in tendo Achillis and the tendons of gastrocnemius and quadriceps. 2 Yang et. al. 3 reported an incidence of calcification in gastrocnemius of 31.9% (44/138) in patients with CPPD crystal deposition in the knee. In patients with tendonitis of gastrocnemius, there often is marked tenderness in the region of the origin of the tendon of the medial head with posterior knee pain induced by stretching the tendon.
References:
- Martel W, McCarter DK, Solsky MA, et al. Further observation of the arthropathy of calcium pyrophosphate dihydrate crystal deposition disease. Radiology 1981;141:1-15.
- Pereira ER, Brown RR, Resnick D. Prevalence and patterns of tendon calcification in patients with chondrocalcinosis of the knee: radiologic study of 156 patients. Clin Imaging 1998;22:371-5.
- Yang BY, Sartoris DJ, Resnick D, Clopton P. Calcium pyrophosphate dihydrate crystal deposition disease: frequency of tendon calcification about the knee. J Rheumatol 1996;23:883-8.
- Ryan LM, McCarty DJ. Calcium pyrophosphate crystal deposition disease:pseudogout: articular chondrocalcinosis. In: McCarty DJ, ed. Arthritis and allied conditions: a textbook of rheumatology. Philadelphia: Lea & Febiger,1989:1711-36.
