PMC8358067_01
Preoperative knee X-ray of the patient. (A) Lateral view showed meniscus (white arrowheads) and gastrocnemius tendon (red arrowheads) calcification. (B) Antero-posterior view showed medial and lateral meniscus calcification (black arrowheads).
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F1
Moreover, X-ray examination showed chondrocalcinosis of the medial and lateral meniscus (Figure 1). ACL, PCL tibial insertion, and lateral meniscus posterior and anterior horn insertions (Figure 3 and Supplementary Video 1). According to the views from coronal, axial, and sagittal planes, multiples intra-substance calcifications within the whole ACL structure and diameter were appreciated.
Previous elbow and shoulder X-ray obtained for minor traumatic events revealed the presence of CPPD crystal deposition (white arrowheads) at the level of writs flexors insertion at medial epicondyle (A,B) and rotator cuff (C) as well.
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Previous elbow and shoulder radiographs obtained for minor traumatic events revealed the presence of CPPD at the level of rotator cuff and writs flexors insertion at medial epicondyle as well (Figure 2).
(A) The specimen. (B) 3D model of intercondylar notch, tibial plateau, cartilage (blue), ACL (orange) and PCL (yellow) tibial insertions, and lateral meniscus posterior and anterior horn insertions (red). Calcifications (gray) within the cruciate ligaments and the meniscal insertions supplemental fibers were linear in shape. (C) Antero-posterior view of ACL, PCL, and lateral meniscus tibial insertions. (D) Axial view of ACL, PCL, and lateral meniscus tibial insertions. (E,F) Sagittal view of the tibial plateau, ACL, and lateral meniscus tibial insertions.
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ACL, PCL tibial insertion, and lateral meniscus posterior and anterior horn insertions (Figure 3 and Supplementary Video 1). According to the views from coronal, axial, and sagittal planes, multiples intra-substance calcifications within the whole ACL structure and diameter were appreciated.
muCT cross sections. Calcifications are highlighted with red arrowheads. Sagittal views of ACL (A) and PCL (B) showed a linear pattern of the cruciate ligament calcifications. On the coronal plane, calcifications of ACL were characterized by an oval shape due to the virtual cut along their shortened diameter (C). Sagittal views of lateral meniscus posterior horn insertion and flat menisco-tibial ligament (D) showed linear pattern calcifications, while the triangular meniscal remnant showed round or oval calcification both in the sagittal (E) and in the coronal (F) view.
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ACL (Figure 4A). A similar pattern was present in the distal part of the PCL included in the specimen (Figure 4B). Differently, on the coronal plane centered on the tibial insertion (Figure 4C), it was possible to note the calcifications with an oval shape, due to the virtual cut along their shorted diameter. A similar presentation was noted for the flat menisco-tibial ligament at the posterior horn insertions of the lateral meniscus included in the specimen where calcifications were linear on sagittal cuts (Figure 4D). Differently, calcifications within the triangular meniscal remnant were observed to be round or oval in shape in all planes (Figures 4E,F).