Learn About Calcium Pyrophosphate Arthritis
View Main Condition: Arthritis
Calcium pyrophosphate dihydrate (CPPD) arthritis is a joint disease that can cause attacks of arthritis. Like gout, crystals form in the joints. But in this arthritis, the crystals are not formed from uric acid.
Calcium pyrophosphate dihydrate deposition disease; CPPD disease; Acute/chronic CPPD arthritis; Pseudogout; Pyrophosphate arthropathy; Chondrocalcinosis
Deposition of calcium pyrophosphate dihydrate (CPPD) causes this form of arthritis. The buildup of this chemical forms crystals in the cartilage of joints. This leads to attacks of joint swelling and pain most often in the knees, wrists, ankles, and shoulders. Other joints can be affected as well. In contrast to gout, the metatarsal-phalangeal joint of the big toe is not affected.
Among older adults, CPPD is a common cause of sudden (acute) arthritis in one joint. The attack may be caused by:
- Injury to the joint
- Medical stress
CPPD arthritis mainly affects the elderly because joint degeneration and osteoarthritis increases with age. Such joint damage increases the tendency of CPPD deposition. However, CPPD arthritis is also more common in people with:
- Hemochromatosis
- Parathyroid gland disease
- Dialysis-dependent renal failure
In most cases, CPPD deposits do not cause any symptoms. Instead, x-rays of affected joints such as knees show characteristic deposits of calcium.
Some people with chronic CPPD deposits in large joints may have the following symptoms:
- Pain
- Swelling
- Warmth
- Redness
Attacks of joint pain can last for months. There may be no symptoms between attacks.
In some people CPPD arthritis causes severe damage to a joint.
CPPD arthritis can also occur in the upper and lower spine. Pressure on spinal nerves may cause pain in the arms or legs.
Because the symptoms are similar, CPPD arthritis can be confused with:
- Gouty arthritis (gout)
- Osteoarthritis
- Rheumatoid arthritis
Treatment may involve removing fluid to relieve pressure in the joint. A needle is placed into the joint and fluid is aspirated. Some common treatment options are:
- Steroid injections: to treat severely swollen joints
- Oral steroids: to treat multiple swollen joints
- Nonsteroidal anti-inflammatory medicines (NSAIDs): to ease the pain
- Colchicine: to treat attacks of CPPD arthritis
- For chronic CPPD arthritis in multiple joints, methotrexate or hydroxychloroquine may be helpful
Proliance Surgeons
Patrick Vaughan, MD, is a board-certified orthopedic surgeon specializing in the care and education of the amateur, professional and weekend athlete. He utilizes both non-operative as well as surgical care in order to restore his patients' function and return them to the activities they love.Dr. Vaughan has been practicing orthopedic surgery in the South Sound for over 15 years. He is the medical director and team orthopedic surgeon for the Tacoma Rainiers (AAA franchise of the Seattle Mariners), and provides sports medicine coverage for Gig Harbor High School. He is the current team orthopedic surgeon for the University of Puget Sound and has worked with all of the school's varsity sports teams for over a dozen years. He served in the U.S. Navy from 2001-2005 at the Naval Hospital Pensacola as an orthopedic surgeon.He enjoys outdoor activities, such as hiking, skiing, and golf, spending time with his family, and playing sports with his two teenagers. Dr. Vaughan is rated as an Advanced provider by MediFind in the treatment of Calcium Pyrophosphate Arthritis. His top areas of expertise are Knock Knees, Osteoarthritis, Bowlegs, Hip Replacement, and Knee Replacement.
Georgios Filippou practices in Milan, Italy. Mr. Filippou is rated as an Elite expert by MediFind in the treatment of Calcium Pyrophosphate Arthritis. His top areas of expertise are Calcium Pyrophosphate Arthritis, Chondrocalcinosis 2, Tenosynovitis, Arthritis, and Knee Replacement.
Emilio Filippucci practices in Ancona, Italy. Mr. Filippucci is rated as an Elite expert by MediFind in the treatment of Calcium Pyrophosphate Arthritis. His top areas of expertise are Calcium Pyrophosphate Arthritis, Synovitis, Arthritis, and Chondrocalcinosis 2.
Most people do well with treatment to reduce the acute joint pain. A medicine such as colchicine may help prevent repeat attacks. There is no treatment to remove the CPPD crystals.
Permanent joint damage can occur without treatment.
Contact your provider if you have attacks of joint swelling and joint pain.
There is no known way to prevent this disorder. However, treating other problems that may cause CPPD arthritis may make the condition less severe.
Regular follow-up visits may help prevent permanent damage of the affected joints.
Summary: Patients with clinically and genetically confirmed Gitelman Syndrome are screened for CPPD, and the clinical and radiographic manifestations are collected and analyzed.
Summary: The objectives of this study are the assessment of the clinical, radiographical and patient-reported outcomes of SMR Stemless Reverse Shoulder Arthroplasty (LimaCorporate S.p.A.) used as standard of care over a period of at least 2 years of follow-up and the evaluation of the incidence of any complication.
Published Date: March 31, 2024
Published By: Neil J. Gonter, MD, Assistant Professor of Medicine, Columbia University, NY and private practice specializing in Rheumatology at Rheumatology Associates of North Jersey, Teaneck, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
Edwards NL. Crystal deposition diseases. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 252.
Terkeltaub R. Calcium crystal disease: calcium pyrophosphate dihydrate and basic calcium phosphate. In: Firestein GS, Budd RC, Gabriel SE, Koretzky GA, McInnes IB, O'Dell JR, eds. Firestein & Kelley's Textbook of Rheumatology. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 102.