Pseudogout (Calcium Pyrophosphate Dihydrate)

Pradeepa Vimalachandran, MD, MPH Reviewed 06/2018
 


BASICS

DESCRIPTION

  • Autoinflammatory disease triggered by calcium pyrophosphate dihydrate (CPPD) crystal deposition within joints

  • One of many diseases associated with pathologic deposition of crystal; mi...

DIAGNOSIS

HISTORY

  • Presentation often mimics gout (“pseudogout”).

  • Acute CPPD: pain and swelling of ≥1 or more joints; knee involved in 50% of cases; ankle, wrist, toe, and shoulder involvement are also c...

TREATMENT

GENERAL MEASURES

Target symptom relief (reduce inflammation): 
  • Rest and elevate affected joint(s).

  • Apply ice/cool compresses to affected joints.

  • Nonweight bearing on affected joint while painful...

ONGOING CARE

FOLLOW UP RECOMMENDATIONS

Patient Monitoring

Reevaluate response to therapy 48 to 72 hours after beginning treatment; reexamine in 1 week then as needed. 

DIET

No known relationship to diet 

PATIENT EDUCATION

REFERENCES

1 Zhang W, Doherty M, Bardin T, et al. European League Against Rheumatism recommendations for calcium pyrophosphate deposition. Part I: terminology and diagnosis. Ann Rheum Dis.  2011...

ADDITIONAL READING

  • Bruges-Armas J, Bettencourt BF, Couto AR, et al. Effectiveness and safety of infliximab in two cases of severe chondrocalcinosis: nine years of follow-up. Case Rep Rheumatol.  ...

CODES

ICD10

  • M11.20 Other chondrocalcinosis, unspecified site

  • M11.269 Other chondrocalcinosis, unspecified knee

  • M11.29 Other chondrocalcinosis, multiple sites

ICD9

  • 275.49 Other disorders of calcium metaboli...

CLINICAL PEARLS

  • Suspect CPPD in arthritis cases that do not follow a pattern typical of degenerative joint disease (e.g., metacarpophalangeal joints, wrists).

  • Perform arthrocentesis to confirm diagnosi...

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