Paravertebral crystal deposition disease: a retrospective study of clinical presentation, prevalence, and CT imaging findings

Objectives: Paravertebral crystal deposition disease, characterized by the deposition of crystals around the vertebral bodies leading to acute inflammation and pain, is a condition that remains largely unrecognized. This study aims to elucidate the prevalence, clinical features, and CT findings associated with this disease.

Methods: We retrospectively analyzed 14,839 consecutive patients who underwent chest and/or abdominal CT (September 2017 to September 2024) owing to chest, abdominal, or back pain. Cases demonstrating paravertebral calcification with a surrounding soft tissue density of ≥ 5 mm were identified and further evaluated.

Results: Twenty-four cases of paravertebral crystal deposition disease were identified, with a prevalence of 0.16% (95% CI: 0.10, 0.24). The mean age was 46.2 years, with a female predominance (n = 15, 63%). Back pain was the most common presenting symptom (n = 15, 63%). Calcifications were primarily located at the lower thoracic and upper lumbar spine (Th6/7-L1/2) in 18 cases (75%) and in the anterior median to anterior right region of the vertebral body in 21 cases (86%). Mean of maximum CT values of the crystal deposition was approximately 800 HU; in follow-up cases, the depositions either resolved or exhibited morphological changes.

Conclusions: This study adds to the current knowledge base by identifying a 0.16% prevalence of paravertebral crystal deposition disease in patients with torso pain-often overlooked in clinical practice, primarily affecting middle-aged women. CT imaging shows calcifications mainly in the lower thoracic and upper lumbar spine. Considering this self-limiting disease in differential diagnoses can improve diagnostic accuracy and patient management.