Calcium Pyrophosphate Deposition Disease

Excerpt

Calcium pyrophosphate deposition disease (CPPD) is a crystal deposition arthropathy involving the synovial and periarticular tissues. Its clinical presentation may range from being asymptomatic to acute or chronic inflammatory arthritis.

Different terms are used to describe the varied phenotypes of calcium pyrophosphate deposition disease. Acute calcium pyrophosphate (CPP) deposition arthritis, frequently referred to as “pseudogout,” presents as an acute flare of synovitis that resembles acute urate arthropathy (gout). Chronic CPP deposition arthritis informally referred to as pseudo-rheumatoid arthritis may present with a waxing and waning clinical course that may last for several months and resemble rheumatoid arthritis involving the wrists and metacarpophalangeal (MCP) joints. The term chondrocalcinosis describes the characteristic radiological finding of intraarticular fibrocartilage calcification.

The crystals involved in calcium pyrophosphate deposition disease are composed of calcium pyrophosphate dihydrate and commonly affect larger and weight-bearing joints, including the hips, knees, or shoulders. A large number of patients present with underlying joint disease or metabolic abnormalities predisposing to CPP deposition, including osteoarthritis, trauma, surgery, or rheumatoid arthritis.