Hemochromatosis is a systemic disease which affects many organs systems, including the joints, characterized by hemosiderin and calcium pyrophosphate deposition.
For a general discussion, and for links to other system specific manifestations, please refer to the article on hemochromatosis.
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Radiographic features
- chondrocalcinosis: particularly knees and triangular fibrocartilage
- arthropathy
- symmetrical loss of joint space, subchondral cysts
- close association with calcium pyrophosphate deposition disease (CPPD) which is often seen concurrently
- most commonly hands (MCP, carpal, PIP) with the characteristic hook-like (or drooping or beak-like) osteophytes projecting from radial ends of 2nd and 3rd metacarpals
- more extensive involvement from the second to the fifth MCP and radial hook-like osteophytes are more characteristic than in CPPD 3
- hook-like osteophytes may also be seen at ulnar aspect
- can also affect the knee, hip, and elbow
- generalized osteoporosis (~25%) or osteopenia (~40%) 4
Differential diagnosis
On imaging consider:
- calcium pyrophosphate deposition disease (CPPD)
-
osteoarthritis
- distal hand joints rather than MCP joints
- psoriatic arthritis