Last reviewed: 6 Nov 2023
Last updated: 10 Dec 2019
Summary
Definition
History and exam
Key diagnostic factors
- painful and tender joints
- osteoarthritis-like involvement of joints (wrists, shoulders)
- sudden worsening of osteoarthritis
More key diagnostic factors
Other diagnostic factors
- red and swollen joints
- joint effusion and fluctuance
- fever and malaise
Other diagnostic factors
Risk factors
- advanced age
- injury
- hyperparathyroidism
- hemochromatosis
- family history of CPPD
- hypomagnesemia
- hypophosphatasia
- gout
- other metabolic conditions
More risk factors
Diagnostic investigations
1st investigations to order
- arthrocentesis with synovial fluid analysis
- radiographs of affected joints
- serum calcium
- serum parathyroid hormone
- iron studies
- serum magnesium
- serum alkaline phosphatase
More 1st investigations to order
Investigations to consider
- ultrasonography
- CT scan
More investigations to consider
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

Professor of Medicine
Medical College of Wisconsin
Milwaukee
WI
Disclosures
AKR is the author of several articles cited in this topic.
Peer reviewers
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.
Ralph Schumacher, MD
Professor of Medicine
VA Medical Center
Arthritis Clinic
Philadelphia
PA
Disclosures
RS declares that he has no competing interests. We have since been made aware that RS is deceased.
Differentials
- Acute gouty arthritis
- Acute septic arthritis
- Milwaukee shoulder syndrome
More DifferentialsGuidelines
- 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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