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

TL;DR

This study identifies a rare condition called paravertebral crystal deposition disease, which causes back pain and is often missed in diagnosis.

Contribution

The study reports a 0.16% prevalence of paravertebral crystal deposition disease in torso pain patients, highlighting its clinical features and CT imaging patterns.

Findings

The disease predominantly affects middle-aged women and presents with back pain.

CT imaging reveals calcifications mainly in the lower thoracic and upper lumbar spine.

The condition is often self-limiting, with calcifications resolving or changing over time.

Abstract

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.

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.

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.

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.

The online version contains supplementary material available at 10.1007/s00256-025-04874-w.

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