Edit concept Question Editor Create issue ticket

Calcium Pyrophosphate Arthropathy

Calcium Pyrophosphate Dihydrate Crystal Deposition Disease


Presentation

  • 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]
  • 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]
  • CPPD disease, however, can mimic rheumatoid arthritis or polymyalgia rheumatica, and patients may present with symmetrical joint involvement.[bpac.org.nz]
  • Chronic pseudogout can present as pseudo-osteoarthritis or pseudorheumatoid arthritis.[musculoskeletalkey.com]
  • Robert Terkeltaub, presents the state-of-the-art, clinically-focused coverage you need to manage these increasingly prevalent diseases.[books.google.de]
Pseudotumor
  • A variety of names have been given to massive CPDD, including “tophaceous pseudogout,” “pseudotumor,” “destructive CPDD arthropathy,” and “CPDD deposition disease.”[ajnr.org]
  • Magno WB, Lee SH, Schmidt J (1992) Chondrocalcinosis of the temporomandibular joint: an external ear canal pseudotumor. Oral Surg Oral Med Oral Pathol 73: 262–265 Google Scholar 9.[link.springer.com]
  • Tophaceous Pseudogout This results due to deposition of calcium pyrophosphate material in a large quantity producing a big pseudotumor which is often painful.[boneandspine.com]
Parotid Swelling
  • A patient presented with a parotid swelling, which initially was suspected to be malignant because of the following findings: radiodensity, progression into the joint, osseous destruction of the major ala of the sphenoid and a fine needle aspirate with[cambridge.org]
Bruxism
  • Acute temporomandibular arthritis in a patient with bruxism and calcium pyrophosphate deposition disease. Arthritis Rheum 1982 ; 25 : 353 –355 Zemplenyi J, Caltcaterra TC. Chondrocalcinosis of the temporomandibular joint: a parotid pseudotumor.[ajnr.org]
Jaw Pain
  • Splint therapy during sleep was very effective in reducing jaw pain on movement. Because synovial chondromatosis of the left TMJ wassuspected, total extirpation of the calcified masses was performed via a preauricular approach.[ci.nii.ac.jp]
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]
Meningism
  • Ferri’s popular "5 books in 1" format provides quick guidance on short QT syndrome, microscopic polyangiitis, fungal meningitis, and much more. This medical reference makes the answers you need even easier to find - anytime, anywhere.[books.google.de]

Workup

  • Septic arthritis workup. Medscape Reference. Available online at . Accessed 9/9/2016. Sofronescu, A. (Updated 2016 April 13). Joint fluid interpretation. Medscape Reference. Available online at . Accessed 9/9/2016. Fisher, M. and Genzen, J. R.[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.[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]
Nephrolithiasis
  • Ectopic calcifications in 70 individuals from 12 families * Family 1 1/F ASY 42 – – 2/F 32 42 Osteopoikilosis, nephrolithiasis – 3/M 40 74 Osteopoikilosis – 4/M ASY 46 Osteopoikilosis, nephrolithiasis – Family 2 1/M 42 64 Nephrolithiasis 2/M 41 53 Nephrolithiasis[onlinelibrary.wiley.com]
  • Hyperuricemia can cause uric acid nephrolithiasis and, possibly, nephropathy, if uric acid accumulates in the renal interstitium and tubules.[clevelandclinicmeded.com]
Soft Tissue Calcification
  • It should be included in the differential diagnosis of periarticular soft tissue calcifications because this disease may commonly mimic a bone tumor. Unenhanced CT is the best imaging technique to establish the diagnosis.[ajnr.org]
  • Possible imaging differential considerations include osteoarthritis usually have the typical weight-bearing distribution giant cell tumor (GCT) subchondral cysts of CPPD can be large and simulate subchondral GCT soft tissue calcification differential[radiopaedia.org]

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]
  • Calcium pyrophosphate crystal deposition disease: diagnosis and treatment. Open Access Rheumatology : Research and Reviews. 2014;6:39-47. doi:10.2147/OARRR.S39039 MacMullan P, McCarthy G.[rarediseases.org]
  • 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 584 35 Osteoporosis C Treatment[books.google.de]
  • 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 [ 2 ] Acute attacks usually resolve within ten days. [ 9 ] Some patients develop progressive joint damage with functional limitation. Prognosis will also be dependent on any underlying cause.[patient.info]
  • […] 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]
  • According to McCarty, the five most common presentations of CPDD are as follows: Asymptomatic (lanthanic) CPDD Acute pseudogout Pseudo-osteoarthritis Pseudorheumatoid arthritis Pseudoneuropathic joints Prognosis Patients with CPDD can experience significant[emedicine.medscape.com]

Etiology

  • Etiology The cause of calcium pyrophosphate arthritis is unknown.[merckmanuals.com]
  • The most likely etiology of the patient's knee pain is characterized by which finding? Review Topic QID: 1398[orthobullets.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]
  • 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]
  • Introduction Clinical definition a metabolic arthropathy due to deposition of calcium pyrophosphate dihydrate (CPP) in connective tissue Epidemiology risk factors radiographic CPP deposition increases with age Etiology CPP deposition in joints Pathogenesis[medbullets.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]
  • […] occurring, higher doses are administered. [3] If nothing else works, hydroxychloroquine or methotrexate may provide relief. [12] Research into surgical removal of calcifications is underway, however this still remains an experimental procedure. [3] Epidemiology[en.wikipedia.org]
  • Epidemiology Autosomal Dominant inheritance and sporadic cases III. Associated Conditions IV.[fpnotebook.com]
  • […] 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]
Sex distribution
Age distribution

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]
  • 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]
  • Pathophysiology of Calcium Pyrophosphate Deposition Disease Calcium pyrophosphate deposition disease consists of the deposition of calcium pyrophosphate crystals into soft tissue.[boneandspine.com]
  • Subsequent messenger RNA expression analysis of the relevant genes in this pathway, in articular cartilage of independent patients undergoing joint replacement surgery for osteoarthritis, showed that upregulation of TNFRSF11B is a general phenomenon in the pathophysiological[emedicine.medscape.com]
  • Patients with serum urate levels 7 mg/dL have an annual incidence below 1%; for patients with serum urate levels 9 mg/dL, the incidence is more than 5%. 7 Pathophysiology Gout is an inflammatory crystal arthropathy resulting from the pathogenic effect[clevelandclinicmeded.com]

Prevention

  • With coverage of the latest therapies, preventions, and imaging studies, along with access to the fully searchable text online at www.expertconsult.com, this comprehensive resource is ideal for any physician who diagnoses, treats, and manages gout and[books.google.de]
  • 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]
  • […] acute pseudogout, treatments include intra-articular corticosteroid injection, systemic corticosteroids, non-steroidal anti-inflammatory drugs (NSAIDs), or, on occasion, high-dose colchicine . [3] In general, NSAIDs are administered in low doses to help prevent[en.wikipedia.org]

Ask Question

5000 Characters left Format the text using: # Heading, **bold**, _italic_. HTML code is not allowed.
By publishing this question you agree to the TOS and Privacy policy.
• Use a precise title for your question.
• Ask a specific question and provide age, sex, symptoms, type and duration of treatment.
• Respect your own and other people's privacy, never post full names or contact information.
• Inappropriate questions will be deleted.
• In urgent cases contact a physician, visit a hospital or call an emergency service!