Knee CPPD and?

[Michael Shilton]

Hi Steve
This knee looks to have CPPD in his meniscus and femoral trochlear. You mention fluid around popliteus is often normal physiological, this chap has some, there is also a small amount of neo vascularisation and some abnormal hyperechoic areas adjacent to the tendon and straddling the lat meniscus so I’m wondering what to make of this? He has extra fluid in the supra patella recess and a Bakers cyst. Does CPPD lead to this amount of fluid? I’m leaning towards possible meniscal injury too. He’s already improved after one treatment so he is not inclined to go for MRI at this stage. Thanks, Mike.

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[Stephen Bird]

Nice one Mike,

I agree there is a small amount of CPPD in the meniscus and also the trochlear cartilage. (you will likely see the meniscal CPPD on the AP radiograph).
There is also a joint effusion.
The colour flow you see around the popliteus tendon is indicating some knee joint synovitis and if you use the colour on the supra-patellar recess effusion margins you would se flow there also.

I agree this is all consistent with a patient having a meniscal injury (not that we can see it) with a joint effusion and then some synovitis of the joint and concurrently they have some CPPD as well adding to the mix.

Really nice work Mike and great images.

Steve

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