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Hydroxyapatite crystal deposition disease (HADD) of the hand and wrist is rare but can cause acute inflammatory syndromes that mimic infectious arthritis. These symptoms, which rapidly resolve with systemic anti-inflammatory drugs, are a source of diagnostic errors and inappropriate treatment. It is of crucial importance to make the diagnosis in order to avoid iatrogenic surgical management. The aim of this study was to determine the clinical and radiographic signs and the key features on which diagnosis depends. Treatment effectiveness and the course of the disease were also examined. Between 1992 and 2008, 12 patients consulted for an isolated acute local inflammatory syndrome of the hand or wrist, which was accompanied by a unique radiographic picture of calcific density. All patients were reassessed clinically and radiographically with a minimum follow-up of 2 years. All patients had presented with acute local inflammatory syndromes. Nine patients had edema and 8 had swelling and erythema. No patient had fever. The course was favorable in 11 patients and one patient required surgery. No patient had a recurrence at the mean final follow-up of 90 ± 64 months. The symptoms associated with hydroxyapatite crystal deposits suggest septic arthritis with acute joint inflammation. The radiological appearance is characteristic and corrects the diagnosis. Oral anti- inflammatory treatment gives more rapid spontaneous improvement, with complete and long-lasting resolution. [ABSTRACT FROM AUTHOR]

Background: Causality has not been formally demonstrated between carpal tunnel syndrome and osteoarthritis of the wrist or at the base of the thumb. The purpose of this study was to assess the relationship between carpal tunnel syndrome and concomitant degenerative osteoarthritis of the wrist or basal thumb joint. We hypothesised that wrist osteoarthritis by reducing the free volume of the carpal tunnel would be associated with carpal tunnel syndrome, while basal thumb osteoarthritis would show no direct correlation with carpal tunnel syndrome. Methods: A case-control study including 95 cases and 99 control subjects, has been carried out. Sixty-eight per group were matched for age and sex. Posterior-anterior and lateral plain wrist radiographs for the two matched groups were analysed. Results: Except for scaphotrapeziotrapezoid location, degenerative osteoarthritis of the wrist was significantly linked with carpal tunnel syndrome, whereas there was no significant difference between case and control groups for prevalence of basal osteoarthritis of the thumb. Conclusions: These results suggest that basal osteoarthritis of the thumb is not a causal factor in carpal tunnel syndrome. In contrast, degenerative osteoarthritis of the wrist was strongly associated with carpal tunnel syndrome, suggesting a causal relation. [ABSTRACT FROM AUTHOR]