Presentation
Patients can present with fever and... References: McCarty DJ, Hollander JL. Identification of urate crystals in gouty synovial fluid. Ann Intern Med 1961; 54:452-460. McCarty DJ, Kohn NN, Faires JS. [posterng.netkey.at]
The presenting symptoms are similar to both gout and septic arthritis but may be treated differently. This article describes a typical patient presentation and management from an emergency medicine and orthopedic surgery standpoint. [journals.lww.com]
Acute CPPD crystal arthritis (pseudogout) presents with severe acute or subacute pain, swelling, erythema, and warmth, of one or more joints and is usually self-limited. The presentation classically resembles an acute gout attack. [radiopaedia.org]
We report a 50-year-old woman who presented with an acute herniated disc syndrome secondary to an intraspinal inflammatory calcium pyrophosphate deposition disease mass at the level of the L4-L5 interspace. [ncbi.nlm.nih.gov]
Entire Body System
- Disability
A CPPD attack can occur suddenly and cause intense pain, inflammation, and disability. [verywellhealth.com]
Please enable JS and disable any ad blocker [rheumatologynetwork.com]
Prognosis Some forms may be severe and result in considerable pain and disability. The documents contained in this web site are presented for information purposes only. [orpha.net]
Presentation Symptoms asymptomatic (most cases) acute attack (pseudogout) typically affects the wrists, knees, and metacarpophalangeal joints are clinically indistinguishable from gout symptoms and physical exam findings include pain erythema warmth swelling disability [medbullets.com]
- Surgical Procedure
Surgical procedures, especially parathyroidectomy, and severe medical illness may precipitate acute pseudogout attacks. Chronic pseudogout can present as pseudo-osteoarthritis or pseudorheumatoid arthritis. [musculoskeletalkey.com]
Gastrointestinal
- Gastropathy
Avoid NSAIDs in patients at risk for gastrointestinal (GI) bleeding, GI intolerance, or gastropathy; renal failure; hepatic failure; congestive heart failure; asthma; or hypersensitivity to NSAIDs. [clevelandclinicmeded.com]
Musculoskeletal
- Fracture
On the other hand, SNAC wrist develops following a scahpoid fracture that has progressed to a nonunion. [ncbi.nlm.nih.gov]
Differential diagnosis Acute arthritis Pseudogout acute attacks should be differentiated from other causes of acute monoarthritis such as: Infection Fracture Osteonecrosis Meniscal tear Plant thorn synovitis Chronic inflammatory arthritis Chronic CPP [wikidoc.org]
Harato K, Yoshida H; Pseudogout at the knee joint will frequently occur after hip fracture and lead to the knee pain in the early postoperative period. J Orthop Surg Res. 2015 Jan 1410:4. doi: 10.1186/s13018-014-0145-9. [patient.info]
The prevertebral fluid collections in this entity (Figure 9) tend to be smooth, linear/lenticular and do not contain an enhancing wall as one would expect with an abscess. 27 Misdiagnoses, such as suppurative retropharyngeal infection, fracture dislocation [appliedradiology.com]
Otherwise you might be at risk of developing the condition osteoporosis, which causes bones to thin and fracture. [versusarthritis.org]
- Knee Pain
(SBQ07SM.13) A 53-year-old male laborer presents to his primary care physician with complaints of acute onset of left knee pain. He has had mild episodes of knee pain in the past and is two years status post a left partial medial meniscectomy. [orthobullets.com]
Snapshot A 70-year-old man presents to the emergency department for severe left knee pain. Medical history is significant for hyperparathyroidism managed with bisphosphonates. [medbullets.com]
Harato K, Yoshida H; Pseudogout at the knee joint will frequently occur after hip fracture and lead to the knee pain in the early postoperative period. J Orthop Surg Res. 2015 Jan 1410:4. doi: 10.1186/s13018-014-0145-9. [patient.info]
Patient education For patient education information, see the Arthritis Center, as well as Knee Pain. [emedicine.medscape.com]
- Neuropathic Arthropathy
A Hematologic and Malignant Disorders 470 25 Less Common Arthropathies B Rheumatic Disease and Endocrinopathies 479 25 Less Common Arthropathies C Hyperlipoproteinemia and Arthritis 484 25 Less Common Arthropathies D Neuropathic Arthropathy 488 25 Less [books.google.de]
Pseudo-neuropathic Arthropathy Pseudo-neuropathic arthropathy is an unusual subtype of CPPD-related arthropathy, which is not fully understood yet. [cureus.com]
Severe joint degeneration : Neuropathic arthropathy is characterized by severe joint degeneration and disruption occurring in the course of neurologic disorders leading to joint denervation; the affected joint is often called a Charcot joint. [wikidoc.org]
Pseudo-neuropathic arthropathy: Some patients with CPPD disease have a dramatic destructive monoarthritis similar to that seen in neuropathic joints. [rheumatologyadvisor.com]
- Arthralgia
In addition, induction of transient arthralgias in some patients is a well-recognized adverse effect of MTX [18], which could have further obscured a potential beneficial effect. [arthritis-research.biomedcentral.com]
The most frequently reported adverse effects are diarrhea, back pain, headaches, and arthralgias. Also, patients should be monitored for thromboembolic events and increased hepatic transaminases. [clevelandclinicmeded.com]
Neurologic
- Lethargy
Symptoms include lethargy, muscle weakness (which, as the level of calcium increases, can progress to depressed reflexes and hypotonic muscles), constipation, mental confusion, and coma. [medical-dictionary.thefreedictionary.com]
Workup
Septic arthritis workup. Medscape Reference. Available online at http://emedicine.medscape.com/article/236299-workup#c8. Accessed 9/9/2016. Sofronescu, A. (Updated 2016 April 13). Joint fluid interpretation. Medscape Reference. [labtestsonline.it]
Subsequent workup showed normal parathyroid hormone, normal calcium and phosphorous levels, and normal magnesium and alkaline phosphatase. [err.eg.net]
(See Etiology, Presentation, and Workup.) Calcium pyrophosphate deposition disease. Radiograph of the knee showing chondrocalcinosis involving the meniscal cartilage, as well as evidence of osteoarthritis. Calcium pyrophosphate deposition disease. [emedicine.medscape.com]
Gout or hyperuricemia in an adolescent or child is rare but invariably a manifestation of an underlying metabolic or inherited enzyme deficiency warranting a workup for these diseases. Postmenopausal women. [clevelandclinicmeded.com]
X-Ray
- Nephrolithiasis
– 5/M 55 82 + + + + − − + + – – 6/F 42 46 + − − + + + + − Shoulder calcification – 7/F 45 59 + + − + + + + − Nephrolithiasis + 8/M 22 57 + + − + − + + − Nephrolithiasis, Osgood-Schlatter disease – 9/M 18 79 + + + + + + + + Nephrolithiasis – 10/M 40 75 [onlinelibrary.wiley.com]
Hyperuricemia can cause uric acid nephrolithiasis and, possibly, nephropathy, if uric acid accumulates in the renal interstitium and tubules. [clevelandclinicmeded.com]
Serum
- Dyslipidemia
It is essential to treat conditions causing the metabolic syndrome, such as hypertension, overweight, dyslipidemia, and insulin resistance, in addition to treating gout. [clevelandclinicmeded.com]
Treatment
Recommendations for the management of CPPD disease tend to be based on expert opinion or extrapolated from research on the treatment of gout.15 Treatment of an acute attack Treatments to reduce the pain and swelling associated with an acute attack of [bpac.org.nz]
Treatment may involve removing fluid to relieve pressure in the joint. [healthing.ca]
Treatment of pseudogout attacks is with intra-articular corticosteroids or oral glucocorticoids, NSAIDs, or colchicine. [merckmanuals.com]
Prognosis
Prognosis The prognosis for individual attacks of acute calcium pyrophosphate arthritis is usually excellent. [merckmanuals.com]
Prognosis Some forms may be severe and result in considerable pain and disability. The documents contained in this web site are presented for information purposes only. [orpha.net]
[…] synovial fluid leading to a synovitis Associated conditions hemochromatosis hyperparathyroidism hypomagnesemia can be seen in Gitelman and Bartter syndrome joint trauma, surgery, and severe medical illness these conditions can provoke an acute attack Prognosis [medbullets.com]
Etiology
The most likely etiology of the patient's knee pain is characterized by which finding? Review Topic QID: 1398 [orthobullets.com]
Prevalence Widespread in older population M:F = 3:2 Clinical findings Intermittent attacks May be mono-articular or polyarticular (more often) Pain Redness Swelling Types Frequently occurs in association with osteoarthritis Aging process with no known etiology [learningradiology.com]
Etiology The cause of calcium pyrophosphate arthritis is unknown. [merckmanuals.com]
Etiology Although the exact mechanism for the development of CPDD remains unknown, increased adenosine triphosphate breakdown with resultant increased inorganic pyrophosphate in the joints results from aging, genetic factors, or both. [emedicine.medscape.com]
[…] forearm) 712.24 (hand) 712.25 (pelvic region and thigh) 712.26 (leg) 712.27 (ankle and foot) 712.28 (other specified site) 727.82 (calcium deposites in tendon and bursa) 712.3 Chondrocalcinosis, unspecified 275.4 Disorders fo calcium metabolism Pseudogout Etiology [eorif.com]
Epidemiology
His research is focused on a number of key elements in OA including (but not limited to) the epidemiology of osteoarthritis, the application of imaging to better understand structure and function with application to both epidemiologic research and clinical [books.google.de]
Epidemiology Autosomal Dominant inheritance and sporadic cases III. Associated Conditions IV. [fpnotebook.com]
Richette P, Bardin T, Doherty M; An update on the epidemiology of calcium pyrophosphate dihydrate crystal deposition disease. Rheumatology (Oxford). 2009 Jul48(7):711-5. Epub 2009 Apr 27. [patient.info]
[…] hand) 712.25 (pelvic region and thigh) 712.26 (leg) 712.27 (ankle and foot) 712.28 (other specified site) 727.82 (calcium deposites in tendon and bursa) 712.3 Chondrocalcinosis, unspecified 275.4 Disorders fo calcium metabolism Pseudogout Etiology / Epidemiology [eorif.com]
Pathophysiology
Neoplasms of the Joint 543 31 Heritable Disorders of Connective Tissue 549 32 Bone and Joint Dysplasias 559 33 Osteonecrosis 565 34 Pagets Disease of Bone 573 35 Osteoporosis A Epidemiology and Clinical Assessment 576 35 Osteoporosis B Pathology and Pathophysiology [books.google.de]
To learn the pathophysiology of this disorder. To understand the clinical manifestations of this disorder. To learn the radiographic distribution and appearance using example radiographs and the target approach to radiographic diagnosis. [posterng.netkey.at]
Definition / general Also called pseudogout, chondrocalcinosis Common finding in arthritic joints Pathophysiology Calcium pyrophosphate dehydrate (CPPD) crystals develop first in menisci and intervertebral discs, may seed the joint and elicit neutrophilic [pathologyoutlines.com]
"Crystal Arthritides: Gout and Calcium Pyrophosphate Arthritis/Part 1: Epidemiology and Pathophysiology." Z Gerontol Geriatr. 2017. DOI: 10.1007/s00391-017-1197-3. [verywellhealth.com]
Terkeltaub RA (2001) Inorganic pyrophosphate generation and disposition in pathophysiology. Am J Physiol Cell Physiol 281: C1–C11 Google Scholar 16. Zemplenyi J, Calcaterra TC (1985) Chondrocalcinosis of the temporomandibular joint. [link.springer.com]
Prevention
Prevention There is no known way to prevent this disorder. However, treating other problems that may cause CPPD arthritis may make the condition less severe. Regular follow-up visits may help prevent permanent damage of the affected joints. [baptistjax.com]
They act in vasospastic angina to relax and prevent coronary artery spasm. [medical-dictionary.thefreedictionary.com]
Experts do not know how to prevent these crystals. If CPPD is due to some other medical problem, treatment of that condition may sometimes prevent CPPD from getting worse. [rheumatology.org]