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Pseudogout (Calcium Pyrophosphate Dihydrate)

Juliana Chang, MD Reviewed 06/2022
 


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 50% of the time; ankle, wrist, toe, and shoulder are also common.

  • Proxim...

TREATMENT

GENERAL MEASURES

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

  • Apply ice/cool compresses to affected joints.

  • Non–weight-bearing on affected joint while painfu...

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
Bilezikian JP, Connor TB, Aptekar R, et al. Pseudogout after parathyroidectomy. Lancet. 1973;1(7801):445-446.
2
Zhang  W, Doherty  M, Bardin  T, et al. European Leagu...

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-...

CODES

ICD10

  • M11.20 Other chondrocalcinosis, unspecified site

  • M11.269 Other chondrocalcinosis, unspecified knee

  • M11.29 Other chondrocalcinosis, multiple sites

SNOMED

  • 201637001 Chondrocalcinosis due to pyrop...

CLINICAL PEARLS

  • Suspect CPPD in arthritis cases that do not follow a pattern typical of degenerative joint disease

  • Perform arthrocentesis to confirm diagnosis.

  • If septic arthritis is suspected, treat em...

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