Calcium pyrophosphate dihydrate crystal deposition disease: Difference between revisions

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'''Calcium pyrophosphate dihydrate crystal deposition disease''' (CPPD), also known as '''pyrophosphate arthropathy''' or '''pseudogout''', is a type of [[arthritis]] that results from the deposition of [[calcium pyrophosphate dihydrate]] (CPPD) crystals in the [[joints]]. This condition can lead to episodes of joint inflammation and pain, which are often mistaken for [[gout]], a similar condition caused by the deposition of [[uric acid]] crystals.
{{SI}}
 
{{Infobox medical condition
== Symptoms and Diagnosis ==
| name                    = Calcium pyrophosphate dihydrate crystal deposition disease
The symptoms of CPPD include sudden, severe joint pain, swelling, and warmth, most commonly affecting the knees, wrists, shoulders, ankles, elbows, or hands. The episodes, often referred to as "attacks," can vary in frequency and intensity. Diagnosis typically involves a combination of clinical evaluation, [[X-ray]] imaging, which may show characteristic calcifications known as "chondrocalcinosis," and analysis of joint fluid to identify CPPD crystals under a microscope.
| image                  = [[File:Birefringence_microscopy_of_pseudogout,_annotated.jpg|left|thumb|Birefringence microscopy of pseudogout]]
 
| caption                = Birefringence microscopy of pseudogout
== Causes and Risk Factors ==
| synonyms                = [[Pseudogout]], [[CPPD]]
The exact cause of CPPD is not fully understood, but it is believed to involve a combination of genetic and environmental factors. Age is a significant risk factor, with the condition more commonly affecting older adults. Other risk factors may include a history of joint injury, certain metabolic disorders such as [[hyperparathyroidism]], and a family history of the disease.
| specialty              = [[Rheumatology]]
 
| symptoms                = [[Joint pain]], [[swelling]], [[redness]], [[warmth]]
== Treatment ==
| complications          = [[Joint damage]], [[osteoarthritis]]
While there is no cure for CPPD, treatment focuses on managing symptoms and preventing future attacks. This may include nonsteroidal anti-inflammatory drugs (NSAIDs) for pain and inflammation, [[colchicine]] to reduce the frequency of attacks, and corticosteroid injections directly into the affected joint for severe cases. Physical therapy may also be recommended to maintain joint function and mobility.
| onset                  = Typically after age 60
 
| duration                = Episodes last days to weeks
== Prognosis ==
| causes                  = [[Calcium pyrophosphate dihydrate crystal]] deposition
The prognosis for individuals with CPPD varies. Some may experience only occasional attacks, while others may develop chronic arthritis with joint damage over time. Early diagnosis and management are crucial to improving quality of life and preventing long-term complications.
| risks                  = [[Age]], [[joint trauma]], [[genetic factors]], [[metabolic disorders]]
 
| diagnosis              = [[Joint aspiration]], [[X-ray]], [[ultrasound]]
| differential            = [[Gout]], [[rheumatoid arthritis]], [[osteoarthritis]]
| treatment              = [[NSAIDs]], [[colchicine]], [[corticosteroids]]
| medication              = [[Nonsteroidal anti-inflammatory drugs]], [[colchicine]]
| frequency              = Common in older adults
}}
{{Short description|A form of arthritis caused by calcium pyrophosphate dihydrate crystal deposition}}
[[File:Birefringence_microscopy_of_pseudogout,_annotated.jpg|left|thumb|Birefringence microscopy of pseudogout]]
'''Calcium pyrophosphate dihydrate crystal deposition disease''' (CPPD), also known as '''pseudogout''', is a form of arthritis characterized by the deposition of [[calcium pyrophosphate dihydrate]] crystals in the [[joints]]. This condition can lead to joint inflammation and pain, similar to [[gout]], but is caused by different types of crystals.
==Pathophysiology==
CPPD occurs when calcium pyrophosphate dihydrate crystals accumulate in the joint cartilage. These crystals can cause inflammation and damage to the joint, leading to symptoms similar to those of other forms of arthritis. The exact mechanism of crystal formation is not fully understood, but it is believed to involve an imbalance in the metabolism of calcium and phosphate.
[[File:Pseudogout_crystals_(calcium_pyrophosphate_dihydrate_crystal).png|left|thumb|Pseudogout crystals (calcium pyrophosphate dihydrate crystal)]]
==Clinical Presentation==
Patients with CPPD may present with sudden onset of joint pain, swelling, and redness, often affecting the knees, wrists, shoulders, ankles, or elbows. The symptoms can mimic those of [[gout]], but unlike gout, CPPD is not caused by [[uric acid]] crystals.
==Diagnosis==
The diagnosis of CPPD is typically made through a combination of clinical evaluation and imaging studies. [[X-ray]]s may show characteristic calcifications in the cartilage, known as [[chondrocalcinosis]]. Joint fluid analysis can reveal the presence of calcium pyrophosphate dihydrate crystals, which can be identified by their rhomboid shape and positive birefringence under polarized light microscopy.
[[File:Calcium_pyrophosphate.png|left|thumb|Calcium pyrophosphate]]
==Treatment==
Treatment of CPPD focuses on relieving symptoms and preventing further joint damage. Nonsteroidal anti-inflammatory drugs ([[NSAIDs]]) are commonly used to reduce pain and inflammation. In some cases, [[colchicine]] or [[corticosteroids]] may be prescribed. Joint aspiration can also provide relief by removing excess fluid and crystals from the joint.
==Prognosis==
The prognosis for patients with CPPD varies. Some individuals may experience only occasional flare-ups, while others may develop chronic arthritis with persistent symptoms. Early diagnosis and management are crucial to prevent joint damage and maintain quality of life.
[[File:Chondrocalcinosis_-_annotated.jpg|left|thumb|Chondrocalcinosis]]
==Related Conditions==
CPPD is often associated with other metabolic disorders, such as [[hyperparathyroidism]], [[hemochromatosis]], and [[hypomagnesemia]]. It is important to evaluate patients for these conditions, as their management may influence the course of CPPD.
==See also==
* [[Gout]]
* [[Arthritis]]
* [[Chondrocalcinosis]]
[[File:Pseudogout_-_high_mag.jpg|left|thumb|Pseudogout - high magnification]]
{{Arthritis}}
[[Category:Arthritis]]
[[Category:Rheumatology]]
[[Category:Rheumatology]]
[[Category:Metabolic disorders]]
[[Category:Crystal deposition diseases]]
 
{{medicine-stub}}
<gallery>
File:Birefringence_microscopy_of_pseudogout,_annotated.jpg|Birefringence microscopy of pseudogout
File:Pseudogout_crystals_(calcium_pyrophosphate_dihydrate_crystal).png|Pseudogout crystals (calcium pyrophosphate dihydrate crystal)
File:Calcium_pyrophosphate.png|Calcium pyrophosphate
File:Chondrocalcinosis_-_annotated.jpg|Chondrocalcinosis
File:Pseudogout_-_high_mag.jpg|Pseudogout - high magnification
File:Calcium_pyrophosphate_dihydrate_crystals_without_and_with_condenser,_annotated.jpg|Calcium pyrophosphate dihydrate crystals without and with condenser
</gallery>

Latest revision as of 21:12, 4 April 2025

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
Founder, WikiMD Wellnesspedia &
W8MD medical weight loss NYC and sleep center NYC

Calcium pyrophosphate dihydrate crystal deposition disease
Birefringence microscopy of pseudogout
Synonyms Pseudogout, CPPD
Pronounce N/A
Specialty Rheumatology
Symptoms Joint pain, swelling, redness, warmth
Complications Joint damage, osteoarthritis
Onset Typically after age 60
Duration Episodes last days to weeks
Types N/A
Causes Calcium pyrophosphate dihydrate crystal deposition
Risks Age, joint trauma, genetic factors, metabolic disorders
Diagnosis Joint aspiration, X-ray, ultrasound
Differential diagnosis Gout, rheumatoid arthritis, osteoarthritis
Prevention N/A
Treatment NSAIDs, colchicine, corticosteroids
Medication Nonsteroidal anti-inflammatory drugs, colchicine
Prognosis N/A
Frequency Common in older adults
Deaths N/A


A form of arthritis caused by calcium pyrophosphate dihydrate crystal deposition


Birefringence microscopy of pseudogout

Calcium pyrophosphate dihydrate crystal deposition disease (CPPD), also known as pseudogout, is a form of arthritis characterized by the deposition of calcium pyrophosphate dihydrate crystals in the joints. This condition can lead to joint inflammation and pain, similar to gout, but is caused by different types of crystals.

Pathophysiology[edit]

CPPD occurs when calcium pyrophosphate dihydrate crystals accumulate in the joint cartilage. These crystals can cause inflammation and damage to the joint, leading to symptoms similar to those of other forms of arthritis. The exact mechanism of crystal formation is not fully understood, but it is believed to involve an imbalance in the metabolism of calcium and phosphate.

Pseudogout crystals (calcium pyrophosphate dihydrate crystal)

Clinical Presentation[edit]

Patients with CPPD may present with sudden onset of joint pain, swelling, and redness, often affecting the knees, wrists, shoulders, ankles, or elbows. The symptoms can mimic those of gout, but unlike gout, CPPD is not caused by uric acid crystals.

Diagnosis[edit]

The diagnosis of CPPD is typically made through a combination of clinical evaluation and imaging studies. X-rays may show characteristic calcifications in the cartilage, known as chondrocalcinosis. Joint fluid analysis can reveal the presence of calcium pyrophosphate dihydrate crystals, which can be identified by their rhomboid shape and positive birefringence under polarized light microscopy.

Calcium pyrophosphate

Treatment[edit]

Treatment of CPPD focuses on relieving symptoms and preventing further joint damage. Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used to reduce pain and inflammation. In some cases, colchicine or corticosteroids may be prescribed. Joint aspiration can also provide relief by removing excess fluid and crystals from the joint.

Prognosis[edit]

The prognosis for patients with CPPD varies. Some individuals may experience only occasional flare-ups, while others may develop chronic arthritis with persistent symptoms. Early diagnosis and management are crucial to prevent joint damage and maintain quality of life.

Chondrocalcinosis

Related Conditions[edit]

CPPD is often associated with other metabolic disorders, such as hyperparathyroidism, hemochromatosis, and hypomagnesemia. It is important to evaluate patients for these conditions, as their management may influence the course of CPPD.

See also[edit]

Pseudogout - high magnification



Arthritis and related conditions
General
Diagnosis
Treatment
Related conditions
Organizations
This Arthritis related article is a stub.
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