Chondrokalzinose des Hüftgelenks

T. Hawellek; J. Hubert; W. Rüther

doi:10.1055/s-0037-1616805

Arthritis und Rheuma, Table of Contents

Arthritis und Rheuma 2016; 36(01): 15-20
DOI: 10.1055/s-0037-1616805

Kinder-rheumatologie/Leitsymptom Hüftschmerz

Schattauer GmbH

Chondrokalzinose des Hüftgelenks

Chondrocalcinosis of the hip

T. Hawellek

¹Klinik für Orthopädie, Klinikum Bad Bramstedt

²Klinik und Poliklinik für Orthopädie, Universitätsklinikum Hamburg-Eppendorf

,

J. Hubert

²Klinik und Poliklinik für Orthopädie, Universitätsklinikum Hamburg-Eppendorf

,

W. Rüther

¹Klinik für Orthopädie, Klinikum Bad Bramstedt

²Klinik und Poliklinik für Orthopädie, Universitätsklinikum Hamburg-Eppendorf

› Author Affiliations

Abstract

Zusammenfassung

Die Chondrokalzinose des Hüftgelenks ist gekennzeichnet durch Calcium-Phosphat-Kristall-Ablagerungen im hyalinen Knorpel der Hüfte und im Faserknorpel des Labrums acetabulare. Physikochemisch wie auch in ihrem pathogenetischen Potenzial werden zwei Gruppen von Calcium-Phosphat-Kristallen unterschieden: BCP-und CPPD-Kristalle. Bei der Chondrokalzinose lassen sich beide Minerale nachweisen. Es ist unklar, ob die beiden Kristallformen eine unterschiedliche Pathogenese und klinische Bedeutung haben. Calcium-Phosphat-Kristalle können das Hüftgelenk sowohl auf biomechanischer als auch auf biochemischer Ebene schädigen. Sie können eine kristallbedingte Synovialitis erzeugen. Möglicherweise tragen auch Nozizeptoren im Labrum actebulare zur Schmerzentstehung im Hüftgelenk bei. Die Prävalenz von Calcium-Phosphat-Kristallen im Hüftgelenk wird durch die schwierige Diagnostik vermutlich unterschätzt. Es steht aktuell nur eine symptomatische Therapie mit antiinflammatorischer Schmerzmedikation zur Verfügung, ein kausaler Therapieansatz fehlt weiterhin.

Summary

Chondrocalcinosis of the hip joint is characterized by calcium phosphate crystal deposition in hyaline cartilage of the hip respectively fibrocartilage of the labrum acetabulare. There are two groups of calcium phosphate crystals, differing in physicochemical and pathogenic potential: BCP- and CPPDcrystals. In joints with chondrocalcinosis both types of crystals can be detected. It is unknown if these crystals have a different pathogenesis and clinical relevance. Calcium phosphate crystals can alter biomechanical and biochemical properties in the hip joint. These crystals can cause a crystal induced synovitis. Moreover nociceptors in the labrum acetabulare contribute to the formation of hip pain. The prevalence of calcium phosphate crystals in the hip joint is probably underestimated, due to the difficulty in detecting these crystals. Until now there is only a symptomatically therapeutic intervention with anti-inflammatory painkillers available, a causal therapeutic intervention is still missing.

Schlüsselwörter

Hüftgelenk - Chondrokalzinose - Calcium-Phosphat-Kristalle - Arthropathie

Keywords

Hip joint - chondrocalcinosis - calcium phosphate crystals - arthropathy

Full Text

References

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