The most commonly affected joint is the knee, but other weight-bearing joints may also be affected, including the hips and shoulders. Up to 50% of these patients may also present with a low-grade fever. In patients presenting with acute calcium pyrophosphate arthritis, manifestations are similar to acute urate arthropathy with joint edema, erythema, and tenderness. Ī large cross-sectional study reported a 4 % crude prevalence of radiographic chondrocalcinosis in the general population. CPPD rarely presents in patients under the age of 60. A cross-sectional study involving 2,157 cases of CPPD in US veterans reported a point prevalence of 5., with an average age of 68 years and 95% of male prevalence. Thirty to fifty percent of patients present over the age of 85 years. Most patients affected by acute calcium pyrophosphate deposition arthritis are over the age of 65. ĭeposition of calcium pyrophosphate is believed to cause activation of the immune system producing inflammation and further soft tissue injury. Other comorbidities associated with it include osteoporosis, hypomagnesemia, chronic kidney disease, and calcium supplementation. In a number of studies, hyperparathyroidism presented the highest positive association with CPPD, followed by gout, osteoarthritis, rheumatoid arthritis, and hemochromatosis. Several comorbidities have correlations with CPPD. As pyrophosphate deposits in the synovium and adjacent tissues, it combines with calcium to form CPP. EtiologyĬalcium pyrophosphate deposition disease is believed to be caused by an imbalance between the production of pyrophosphate and the levels of pyrophosphatases in diseased cartilage. A large number of patients present with underlying joint disease or metabolic abnormalities predisposing to CPP deposition, including osteoarthritis, trauma, surgery, or rheumatoid arthritis. 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. The term chondrocalcinosis describes the characteristic radiological finding of intraarticular fibrocartilage calcification. 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. Acute calcium pyrophosphate (CPP) deposition arthritis, frequently referred to as “pseudogout,” presents as an acute flare of synovitis that resembles acute urate arthropathy (gout). ĭifferent terms are used to describe the varied phenotypes of calcium pyrophosphate deposition disease. Its clinical presentation may range from being asymptomatic to acute or chronic inflammatory arthritis. Explain interprofessional team strategies for improving care coordination and communication regarding the management of patients with calcium pyrophosphate deposition disease.Ĭalcium pyrophosphate deposition disease (CPPD) is a crystal deposition arthropathy involving the synovial and periarticular tissues.Review the therapeutic options available for the management and treatment of calcium pyrophosphate deposition disease.Summarize the diagnostic approach for a patient presenting with potential calcium pyrophosphate deposition disease.Describe the pathophysiology of calcium pyrophosphate deposition disease.This activity reviews the etiology, presentation, evaluation, and management of calcium pyrophosphate deposition disease, and reviews the role of the interprofessional team in evaluating, diagnosing, and managing the condition. Calcium pyrophosphate deposition disease (CPPD) is a crystal deposition arthropathy involving the synovial and periarticular tissues.
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