Chondrocalcinosis M11.29

Mono- or oligoarticular arthritis and synovitis (especially of the knee joint) due to the deposition of calcium pyrophosphate dihydrate (CPPD) crystals(crystal arthropathy).

Idiopathic in old age

Hereditary

Secondary to other diseases

Patients typically suffer from acute onset mono- or oligoarticular arthritis. The severe inflammatory reaction to CPP crystals manifests as warmth, redness and swelling in and around the affected joint, and the clinical picture is often indistinguishable from acute gouty arthritis or septic arthritis. Among other findings, the distribution of joint involvement can provide a helpful clue to the presence of acute CPP crystal arthritis. The knee is most commonly affected, followed by the wrist; acute podagra in the first metatarsophalangeal joint is rare. Acute CPP crystal arthritis often presents with systemic symptoms such as fever, chills and constitutional symptoms. In contrast to the short attacks of acute gouty arthritis, which usually last several days to a week, acute attacks of CPPD disease can last weeks to months.

Radiological: Calcifications in cartilage and tendons

Polarization-optical detection of CCPD crystals in joint punctate

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2. McCarty D Jr et al. (1962) The significance of calcium pyrophosphate crystals in the synovial fluid of arthritic patients: the "pseudogut syndrome." 1. clinical aspects. Ann Intern Med 56: 711-37.
3. Rosenthal AK et al. (2016) Calcium pyrophosphate deposition disease. N Engl J Med 374:2575-2584.
4. Zhang W et al. (2011) European League Against Rheumatism recommendations for calcium pyrophosphate deposition. I. Terminology and diagnosis. Ann Rheum Dis 70: 563-70.