Iliopectineal Bursitis Associated With Calcium Pyrophosphate Crystal Deposition Disease: A Case Report

• Published in: JOURNAL OF THE JAPANESE ASSOCIATION OF RURAL MEDICINE Vol. 69; no. 4; p. 390
• Main Authors: KATO, Tetsuji, YOSHIOKA, Yasuko, YAMAGISHI, Itsuro, KAWAMURA, Fuminori
• Format: Journal Article
• Language: Japanese
• Published: THE JAPANESE ASSOCIATION OF RURAL MEDICINE 2020
• Subjects: Calcium pyrophosphate crystal; Calcium pyrophosphate deposition disease; Iliopectineal bursitis
• ISSN: 0468-2513; 1349-7421
• DOI: 10.2185/jjrm.69.390

A 93-year-old man with a history of calcium pyrophosphate deposition disease (CPPD) in the right shoulder and wrist had severe pain in his right lower limb in the absence of trauma. He was transported by ambulance to our hospital. He was febrile (38℃) and swelling of the inguinal region was noted on physical examination. Laboratory examination showed elevated C-reactive protein (19.1 mg/dL, normal range ＜ 0.3 mg/dL) and white blood cell count (9600/μl, normal range ＜ 9000/μL). X-ray showed calcifications near the hip bilaterally, computed tomography showed distension of the iliopectineal bursa, and magnetic resonance imaging showed a cystic lesion of the iliopectineal bursa. Aspiration was performed under ultrasound guidance. Fluid analysis under an optical microscope revealed calcium pyrophosphate crystals. Bacterial examination was negative. Iliopectineal bursitis associated with CPPD was diagnosed, and he was treated conservatively with NSAIDs. To our knowledge, only 5 cases of iliopectineal bursitis associated with CPPD have been reported in Japan, and here we present the details of this rare case.