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Calcium pyrophosphate deposition disease: The arthropathy formerly known as “Pseudogout”

Many terms, e.g. pseudogout, pseudo-osteoarthritis, pseudo-rheumatoid arthritis, have been used to describe the wide range of clinical syndromes associated with the deposition of calcium pyrophosphate dihydrate crystals in joints. The term “pseudogout” was adopted in 1962 following the first description of calcium phosphate crystals found in the synovial fluid of affected joints in patients with a normal serum urate level.7 The term was chosen to reflect a discrete type of crystal-induced synovitis that resembled an acute attack of gout. Subsequently it has been found that deposition of CPP crystals in joints is not only responsible for acute synovitis, but associated with a wide range of…

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Articles of Interest

Could Your Joint Pain Actually Be ‘Pseudogout?’ Here Are Some Clues

Have you ever heard of calcium pyrophosphate (CPP)? Unless you’re having a specific type of joint pain, we’re guessing not. Calcium pyrophosphate is a normal chemical in the body that helps your bones and joints function. But in some people, the substance builds up into crystals in the cartilage, the connective tissue in your joints, over time and with age. As those crystals accumulate and make their way into the joint fluid, they can irritate or damage the joints, leading to an arthritis known by different names: calcium pyrophosphate dihydrate deposition disease (CPPD), acute CPP crystal arthritis, or pseudogout.

Gout or Pseudogout?

Gout and “pseudogout” — known formally as calcium pyrophosphate dihydrate crystal deposition disease (CPPD) — have such similar symptoms that it usually takes a microscope to know for sure what you’ve got. Each of these painful forms of arthritis is caused by a different type of crystal in the joints, and remedies differ. “The big difference is that gout is a treatable disease. If it can be diagnosed and treated properly, gout can go away completely,” says rheumtologist Alan Baer, MD, professor of medicine and director of the rheumatology clinic at Johns Hopkins Medicine.

Pseudogout

Pseudogout is a type of arthritis that, as the name implies, can cause symptoms similar to gout, but which are a reaction to a different type of crystal deposit. This type of arthritis may be one of the most misunderstood forms, and is often mistaken for gout and other conditions, including RA. Proper diagnosis is important because untreated pseudogout may lead to a severe form of joint degeneration and ongoing inflammation, resulting in chronic disability.

Pseudogout (2nd edition)

The presentation varies. Many patients are asymptomatic, and it is picked up incidentally on an x-ray. Others may present with chronic pain and stiffness in multiple joints. It can present acutely with a rapid onset of symptoms. A typical acute presentation of pseudogout is a patient over 65 years old with a rapid-onset hot, swollen, stiff and painful knee. Other commonly affected joints are the shoulders, hips and wrists.

Pseudogout (CPPD)

Pseudogout is most common in the elderly. It affects about 3% of people in their 60s and as many as half of people in their 90s. Many people who get pseudogout already have joint damage from other conditions, or they may have age-related degenerative joint disease. One theory is that an injury to cartilage allows calcium crystals to be released into the joint space, and these crystals cause inflammation.

Risk factors for pseudogout in the general population

This general population study based on physician-recorded pseudogout suggests that most of the previously observed associations with chondrocalcinosis are replicable with the risk of pseudogout, but there are notable differences, such as thiazide diuretics, RA and chronic renal failure...

Treatment and management of pseudogout: insights for the clinician

Pseudogout and the associated calcium pyrophosphate dihydrate (CPPD)- crystal-related arthropathies are common conditions that present particular management problems in clinical practice as they often affect older patients with multiple medical comorbidities.

Understanding Pseudogout and Its Impact on Your Feet

Pseudogout, also known as calcium pyrophosphate deposition disease (CPPD), is a type of arthritis caused by the accumulation of calcium pyrophosphate dihydrate crystals in the joints. While it can affect various joints in the body, the feet are particularly susceptible, leading to discomfort and mobility issues.

Resources

4 Ways Gout and Pseudogout Are Different

Gout attacks typically affect only one joint. In contrast, pseudogout attacks commonly affect between 1 and 4 joints. In addition, the locations of the flare-ups tend to differ...