Last reviewed: 28 Sep 2021
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

Other diagnostic factors

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

Risk factors

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

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

Treatment algorithm

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

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. 

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