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Calcium pyrophosphate deposition

Last reviewed: 30 Sep 2024
Last updated: 15 Feb 2024

Summary

Definition

History and exam

Key diagnostic factors

  • painful and tender joints
  • osteoarthritis-like involvement of joints (wrists, shoulders)
  • sudden worsening of osteoarthritis
Full details

Other diagnostic factors

  • red and swollen joints
  • joint effusion and fluctuance
  • fever and malaise
Full details

Risk factors

  • advanced age
  • injury
  • hyperparathyroidism
  • hemochromatosis
  • family history of CPPD
  • hypomagnesemia
  • hypophosphatasia
  • gout
  • other metabolic conditions
Full details

Diagnostic tests

1st tests to order

  • arthrocentesis with synovial fluid analysis
  • radiographs of affected joints
  • serum calcium
  • serum parathyroid hormone
  • iron studies
  • serum magnesium
  • serum alkaline phosphatase
Full details

Tests to consider

  • ultrasonography
  • CT scan
Full details

Treatment algorithm

ACUTE

mono- or oligoarticular disease

polyarticular disease

ONGOING

chronic recurrent involvement of knee, hip, or shoulder joint with severe degeneration

with osteoarthritis-like disease or rheumatoid-like disease

Contributors

Authors

Ann K. Rosenthal, MD
Ann K. Rosenthal

Professor of Medicine

Medical College of Wisconsin

Milwaukee

WI

Disclosures

AKR is the author of several articles cited in this topic.

Peer reviewers

Priyanka Iyer, MD

Clinical Assistant Professor

University of California, Irvine

Irvine

CA

Disclosures

PI declares that she has no competing interests.

Ade Adebajo, MBBS, MSc, FRCP (Glasgow), FACP

Consultant Rheumatologist

Rheumatology

University of Sheffield Medical School

Sheffield

UK

Disclosures

AA declares that he has no competing interests.

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  • Guidelines

    • European League Against Rheumatism recommendations for calcium pyrophosphate deposition. Part I: terminology and diagnosis
    • EULAR recommendations for calcium pyrophosphate deposition. Part II: management
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