Pseudogout / CPPD
Background
- Destruction of joints and soft tissues by deposition of Calcium pyrophosphate dihydrate (CPPD) crystals.
- Asymptomatic (majority)
- X-ray: ↓joint space, subchondral sclerosis
- Acute "gout" (hot, red, swollen, and stiff joint)
- Acute mono-arthritis
- Chronic (Pseudorheumatoid) arthritis (5%)
- Oligoarthritris, chronic cooler arthritis, ↑ESR
Clinical
- Sudden onset of intense, constant pain in one joint
- ? triggered by stressor, lasts for 5 - 14 days
- Knee involved in ½ cases (rater than great toe in gout)
- ± pyrexia
- Eventul joint cartilage destructin with loose bodies and erosions
Differential Dx
- Gout
- Septic arthritis
- Rheumatoid arthritis
Investigations
- Plain x-rays (chondrocalcinosis,
- Synovial fluid aspiration (
Management
- No cure - aim for management
- NSAIDs
- ±steroids
- GP long term Mx
Links
Content By Dr Íomhar O' Sullivan 19/12/2014. Last review Dr ÍOS 16/12/19.