Hemochromatosis (skeletal manifestations)

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. 

Radiographic features

• chondrocalcinosis: particularly knees and triangular fibrocartilage
• arthropathy
  • symmetrical loss of joint space, subchondral cysts 
  • close association with CPPD which is often seen concurrently
  • most commonly hands (MCP, carpal, PIP) with the characteristic beak-like osteophytes projecting from radial ends of 2^nd and 3^rd metacarpals

    • more extensive involvement from the second to the fifth MCP and radial hook-like/drooping osteophytes are more characteristic than in CPPD ³

  • can also affect the knee, hip, and elbow  
• generalised osteoporosis (~25%) or osteopaenia (~40%) ⁴

Differential diagnosis

On imaging consider:

• calcium pyrophosphate deposition disease (CPPD)
• osteoarthritis 
  • distal hand joints rather than MCP joints
• psoriatic arthritis

See also

• polyarticular disease