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Calcium Pyrophosphate Deposition Disease (CPPD) (Pseudogout), Sports Medicine

Kenneth Bielak, MD, FACSM, FAAFP, CAQSM Reviewed 04/2019
 


BASICS

DESCRIPTION

  • Calcium pyrophosphate deposition disease (CPPD) is a crystal arthropathy characterized by deposition of calcium pyrophosphate (CaPPi) dihydrate crystals in joints.

  • Synonym(s):

    • Pseudogo...

DIAGNOSIS

HISTORY

  • Acute joint swelling in one or more joints with previous episodes involving the same joint (characteristic of crystal arthropathies)

  • The most common joint is the knee, followed by the ...

TREATMENT

  • Acute treatment:

    • Joint aspiration often significantly reduces pain 7[C].

    • Intra-articular corticosteroid injection can be effective 8[C].

    • Joint rest and splinting if needed

    • Nonsteroidal anti-infl...

ONGOING CARE

  • Primary metabolic disorders or familial predisposition is uncommon but should be considered if CPPD occurs before 55 yr of age or if there is florid polyarticular CPPD.

  • After the age of 55...

REFERENCES

1
Alvarellos A, Spilberg I. Colchicine prophylaxis in pseudogout. J Rheumatol.  1986;13(4):804–805.
2
Rainer TH, Cheng CH, Janssens HJ, et al. Oral prednisolone in the treatment of acute ...

ADDITIONAL READING

  • Courtney P, Doherty M. Joint aspiration and injection and synovial fluid analysis. Best Pract Res Clin Rheumatol.  2013;27(2):137–169.

  • Couto AR, Brown MA. Genetic factors in the...

CLINICAL PEARLS

  • The cause of CPPD is unknown (unlike gout, in which hyperuricemia leads to precipitation of uric acid crystals into joints).

  • Aspiration of joint fluid is key to diagnosis.

  • There is no pr...

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