Calcium Pyrophosphate Deposition Disease (CPPD)

Question 1

Calcium Pyrophosphate Deposition Disease (CPPD)

Answer 1

Acute CPPD
-slower in onset than gout
-last 1-3 weeks (longer than gout)

Common sites
1) knee
2) wrist
3) ankles, elbow, toes, shoulder, hip

CPP crystal inflammatory arthritis (arthritis combined with CPP)
-can affect joints less commonly associated wtih osteoarthritis
-more frequent in younger patients (<50yo)
-likely family predisposition

Diagnosis
-synovial sample with bifrigence testing (positive biregringent = CPPD)
-Chondrocalcinosis on Xray series (wrists, pelvis (AP) and knees all together otherwise it can be missed)

Management

Acute
-colchicine 500mcg BD (reduce dose if diarrhoea), monitor renal function, CK, CBE
or NSAIDs or prednisolone (intrarticular if possible, <20mg daily if oral)

Chronic - as for acute (lower doses - colchicine max 500mcg/day) and as per osteoarthritis