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Highlights & Basics
- Calcium pyrophosphate arthritis is caused by deposition of articular calcium pyrophosphate (CPP) crystals.
- It can be difficult to diagnose as CPP crystals in synovial fluid can be small, sparse, and difficult to find.
- In patients <60 years of age, underlying metabolic conditions associated with calcium pyrophosphate deposition (CPPD), such as hyperparathyroidism or hemochromatosis, should be investigated.
- There is no definitive treatment for CPP arthritis, but intra-articular or systemic anti-inflammatory drugs can be effective for both acute and chronic forms.
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Citations
McCarty DJ. Diagnostic mimicry in arthritis: patterns of joint involvement associated with calcium pyrophosphate dihydrate crystal deposits. Bull Rheum Dis. 1975;25:804-809.
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Rosenthal AK, Ryan LM. Calcium Pyrophosphate Deposition Disease. N Engl J Med. 2016 Jun 30;374(26):2575-84.[Abstract][Full Text]
Martinez Sanchis A, Pascual E. Intracellular and extracellular CPPD crystals are a regular feature in synovial fluid from uninflamed joints of patients with CPPD related arthropathy. Ann Rheum Dis. 2005 Dec;64(12):1769-72.[Abstract]
Zhang W, Doherty M, Pascual E, et al. EULAR recommendations for calcium pyrophosphate deposition. Part II: management. Ann Rheum Dis. 2011 Apr;70(4):571-5.[Abstract][Full Text]
Creamer P. Intra-articular corticosteroid treatment in osteoarthritis. Curr Opin Rheumatol. 1999 Sep;11(5):417-21.[Abstract]
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