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Biomedical subjects
M G Pattrick
Publications and source records attributed to M G Pattrick.
Crystal deposition in hypophosphatasia: a reappraisal.
Six subjects (three female, three male; age range 38-85 years) with adult onset hypophosphatasia are described. Three presented atypically with calcific periarthritis (due to apatite) in the absence of osteopenia; two had classical presentation with osteopenic fracture; and one was the asymptomatic father of one of the patients with calcific periarthritis. All three subjects over age 70 had isolated polyarticular chondrocalcinosis due to calcium pyrophosphate dihydrate crystal deposition; four of the six had spinal hyperostosis, extensive in two (Forestier's disease). The apparent paradoxical association of hypophosphatasia with calcific periarthritis and spinal hyperostosis is discussed in relation to the known effects of inorganic pyrophosphate on apatite crystal nucleation and growth.
Adult↗
Peripheral nerve entrapment at the wrist in pyrophosphate arthropathy.
Of 200 consecutive patients with confirmed pyrophosphate arthropathy, clinically significant median nerve entrapment was found in 14 (14%) of those with wrist involvement. Three of these had electromyographically confirmed combined median and ulnar nerve entrapment at the wrist (bilateral in 2). Chondrocalcinosis, but not changes of arthropathy, was closely associated with the presence of entrapment (p less than 0.001), implying that soft tissue factors are important in causation. Treated hypothyroidism was more common in those with nerve entrapment (p less than 0.01), suggesting a possible interaction of multiple factors in the pathogenesis of nerve entrapment.
Adult↗