On X-ray, joint swelling & intra-aicular ‘calcification’ appearance is seen in: September 2004
## **Core Concept**
The question tests the knowledge of radiological features of various joint conditions, specifically those associated with joint swelling and intra-articular calcification. This requires understanding of the characteristic X-ray findings in different arthritic conditions.
## **Why the Correct Answer is Right**
The correct answer, **CPPD (Calcium Pyrophosphate Dihydrate) disease**, also known as pseudogout, is characterized by the deposition of calcium pyrophosphate dihydrate crystals within the joint space. This condition often presents with acute inflammatory arthritis, joint swelling, and can show chondrocalcinosis (calcification of cartilage) on X-ray. The presence of intra-articular calcification is a hallmark feature, which helps differentiate it from other forms of arthritis.
## **Why Each Wrong Option is Incorrect**
- **Option A: Gout**: While gout can cause joint swelling and can have erosive changes on X-ray, it is typically associated with soft tissue swelling and sometimes a "punched-out" lytic lesion but not characteristically intra-articular calcification.
- **Option B: Rheumatoid Arthritis (RA)**: RA can cause joint swelling and erosions but is not typically associated with intra-articular calcification.
- **Option D: Osteoarthritis (OA)**: OA can cause joint swelling and sometimes shows calcification, but the calcification in OA is usually seen as osteophytes or subchondral cysts rather than the characteristic chondrocalcinosis seen in CPPD.
## **Clinical Pearl / High-Yield Fact**
A key clinical pearl is that CPPD disease can mimic gout and other arthritic conditions but is uniquely identified by the presence of calcium pyrophosphate crystals under polarized light microscopy and chondrocalcinosis on X-ray. This condition often affects the knee, wrist, and metacarpophalangeal joints.
## **Correct Answer:** . CPPD disease