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  • Age: 55
  • Sex: male
  • Medical history: Seronegative rheumatoid arthritis. Swelling and pain at the right wrist.

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1: Seronegative RA with wrist pain

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  • Follow-up after therapy with methotrexate. There is continuous swelling and pain in both wrists.Follow-up after therapy with methotrexate. There is continuous swelling and pain in both wrists.later

CPPD arthropathy with marked osteoarthritis

Already on the initial x-ray, a shallow calcification of the styloid process of the radius can be seen. The MRI of the wrist shows pronounced bone marrow edema and synovitis. There are intraosseous cystic changes in the capitate and the alignment between the scaphoid and lunate bone has shifted.

A few years after the initial presentation, an advanced carpal instability can be detected radiographically.

This is a case of pseudo-gout (so-called CPPD arthropathy or chondrocalcinosis). Typical are calcifications of the cartilage and the ligaments, which cause a synovial and osseous inflammatory reaction and can lead to carpal instability.