CPPD Flashcards
1
Q
What crystalises in CPPD disease?
A
Calcium pyrophosphate
2
Q
What are the causes and associations of CPPD?
A
- Idiopathic (most cases)
- Haemochromatosis
- Hyperparathyroidism
- Gout
- Hypomagnesemia
- Familial CPPD disease
- Bisphosphonate therapy
3
Q
What is the pathogenesis of CPPD?
A
- Crystal formation in cartilage near surface of chondrocytes
- ?NLRP3 + inflammasome activation
- Self-limiting akin to gout
4
Q
Clinical manifestations:
1. age group most commonly affected
2. clinical manifestations
A
- > 84 years old (50% of cases)
- May be asymptomatic, present like Gout (but more likely to be knee, wrist, shoulder, elbow), or chronic inflammatory arthritis (often mistaken for RA)
5
Q
What are the microscopic findings on sinovial fluid?
A
Small, weakly positive birefringent, polymorphic (rod-shaped, cuboid, rhomboid)
6
Q
Imaging findings in pseudogout
A
US - double contour sign (but more stippled appearance than the smooth contour of gout)
Dual energy CT - less useful than US
7
Q
Post-diagnostic work up for CPPD includes?
A
CMP, PTH, ALP, Iron studies
8
Q
Management of acute pseudogout
A
- Intra-articular steroids or NSAIDs
9
Q
Most common joint affected in CPPD?
A
Knee (50% of cases)
