Tradition Versus Innovation: Conventional Radiography and Ultrasound in Calcium Pyrophosphate Deposition Identification. Instructions for Use
Authors' conclusion
US was more accurate than CR for identification of CPPD. Performing both exams can be an added value for CPPD identification only in a few specific cases.
Study context
- Population
- Consecutive patients scheduled for knee replacement surgery for OA (63% female, mean age 71.4 [SD 8] years)
- Participants
- 51 patients
- Comparison
- Ultrasound (US) vs conventional radiography (CR), alone and combined, for identification of CPPD
- Outcome
- Accuracy for identification of CPPD vs polarized light microscopy of menisci and hyaline cartilage (gold standard)
Methodological detailsconsecutive patients, polarized light microscopy as gold standard, Poisson models with robust variance estimators
- Consecutive patients
- Polarized light microscopy as gold standard
- Poisson models with robust variance estimators
Performance
As reported in the abstract
Overall accuracy for CPPD identification
| Test or model | Accuracy |
|---|---|
| US | 0.78 |
| CR | 0.73 |
Accuracy
US0.78
CR0.73
Further findings
Sequential use of both modalities
- With a negative CR, a positive US increased the likelihood of CPPD (times)
- 4.21
- With a negative CR, a negative US increased the likelihood of CPPD absence by
- 76%
- Advantage when only 1 knee site was positive in 1 of the 2 techniques; no additional advantage when 2 or 3 sites were positive
- When US was negative, subsequent CR did not improve CPPD detection
Original publication
Tradition Versus Innovation: Conventional Radiography and Ultrasound in Calcium Pyrophosphate Deposition Identification. Instructions for Use. J Rheumatol. Published 1 June 2025. doi:10.
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