CPPD Deposition Disease

Question 1

What is involved in CPPD deposition disease?

Answer 1

Pseudogout
Chondrocalcinosis
Pyrophosphate arthropathy

Question 2

What is pseudogout?

Answer 2

Acute synovitis

Question 3

What is chondrocalcinosis?

Answer 3

Calcification in hyaline cartilage or fibrocartilage

Question 4

What is pyrophosphate arthropathy?

Answer 4

OA with CPPD

Question 5

What are causes of CPPD deposition disease?

Answer 5

**Unknown**
Altered metabolism of pyrophosphate (PPi)
1.  Hereditary (familial)
2. Sporadic (idiopathic)
3. Metabolic
- Hemochromatosis,
- Hyperparathyroidism 
- Hypomagnesemia
- Hypophosphatasia

Extracellular PPi accumulation around chondrocytes

Question 6

What is clinical presentation of chondrocalcinosis?

Answer 6

Asymptomatic
Incidental finding on xray
Pts seek care when there is an acute flair
- Usually from osteoarthritis

Question 7

What is clinical presentation of pseudogout?

Answer 7

Monoarticular
Cardinal signs of inflammation
Not as abrupt onset and tends to last longer
Usually affects large joints
- Most commonly the knee

Question 8

What are diagnostic studies of CPPD deposition disease?

Answer 8

Xray

Synovial Fluid analysis
- Positive birefringence

Question 9

What is the treatment of CPPD deposition disease?

Answer 9

RICE
NSAIDs
Corticosteriods
+/- colchicine