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Calcium pyrophosphate deposition disease (Chondrocalcinosis, Pseudogout)

Wrist pain

What is Calcium pyrophosphate deposition disease (Chondrocalcinosis, Pseudogout)

Pseudogout is a type of crystal arthropathy, like gout. The term crystal arthropathy means that crystals of a chemical (like urate in gout, and calcium pyrophosphate in pseudogout) are precipitating and depositing in the joint, leading to inflammation.

In pseudogout there is deposition of calcium pyrophosphate dihydrate (CPPD) crystals in the joint cartilage and the tissue around the joint. Shedding of the crystals into the joint produces an acute inflamed joint (like in gout) though pseudogout commonly involves the knee and wrist as opposed to gout which affects the big toe commonly. In pseudogout there can be gradual destruction of the joint as well.

Pseudogout - Chondrocalcinosis

Statistics on Calcium pyrophosphate deposition disease (Chondrocalcinosis, Pseudogout)

This condition commonly occurs in elderly women – patients are over 60.

It can occur in men as well.

Risk Factors for Calcium pyrophosphate deposition disease (Chondrocalcinosis, Pseudogout)

The cause of the condition is not known, though there are certain risk factors:

 

  • dehydration
  • intercurrent illness,
  • hyperparathyroidism (causing increased calcium in the blood),
  • myxoedema, diabetes mellitus,
  • decreased phosphate or decreased magnesium,
  • any arthritis,
  • haemochromatosis,
  • hyperthyroidism and
  • gout.

 

Progression of Calcium pyrophosphate deposition disease (Chondrocalcinosis, Pseudogout)

There is no way to predict the course of the disease in a particular patient.

 

  • In some recurrent acute attacks (as in gout but less severe) may be the norm with apparent normality between attacks.
  • Other patients may progress and develop significant joint damage with impairment of function.

 

How is Calcium pyrophosphate deposition disease (Chondrocalcinosis, Pseudogout) Diagnosed?

 

  • Full blood count: – may show a raised white cell count
  • Radiology: may show linear calcification parallel to the articular surfaces (in articular cartilage which is normally radiolucent – chondrocalcinosis)
  • Serum calcium: normal.

 

Prognosis of Calcium pyrophosphate deposition disease (Chondrocalcinosis, Pseudogout)

 

  • Some patients may progress and develop significant joint damage with impairment of function.
  • Treatment may offer symptomatic relief, however, there is unfortunately no treatment for arresting the progress of the disease.unfortunately no treatment for arresting the progress of the disease.

 

How is Calcium pyrophosphate deposition disease (Chondrocalcinosis, Pseudogout) Treated?

As mentioned before, no treatment will abolish the condition. Hence treatment is mainly symptomatic with:

  • NSAIDs. (non-steroidal anti-inflammatory drugs)
  • Colchicine may be used. (used to prevent or treat attacks of gout)
  • Aspiration of the joint will often relieve pain; and
  • If infection is excluded – a steroid injection into the joint will also help.

 

Calcium pyrophosphate deposition disease (Chondrocalcinosis, Pseudogout) References

  1. Braunwald, Fauci, Kasper, Hauser, Longo, Jameson. Harrison’s Principles of Internal Medicine. 15th Edition. McGraw-Hill. 2001
  2. Cotran, Kumar, Collins 6th edition. Robbins Pathologic Basis of Disease. WB Saunders Company. 1999.
  3. Hurst JW (Editor-in-chief). Medicine for the practicing physician. 4th edition Appleton and Lange 1996.
  4. Kumar P, Clark M. CLINICAL MEDICINE. WB Saunders 2002 Pg 427-430.
  5. Longmore M, Wilkinson I, Torok E. OXFORD HANDBOOK OF CLINICAL MEDICINE. Oxford Universtiy Press. 2001
  6. Murtagh, J. General Practice. Second Ed. McGraw-Hill, 1998.

Dates

Posted On: 5 September, 2003
Modified On: 13 March, 2014

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