Introduction

An inflammation of the synovial joints, or arthritis, is a common illness that "frequently

produces severe joint pain, along with swelling, stiffness, and decreased joint motion"

(OpenStax, 2108). According to Khan Academy (2019), the causes of arthritis can be

classified into four categories: overuse, autoimmune, infection, and depository. 

A synovial joint is one in which the area between the articulating surfaces of the bones that

come into contact with one another has a joint cavity that is filled with synovial fluid. By

allowing the bones to move more easily against one another, synovial fluid can improve joint

mobility. However, damage at the synovial joint is what causes one type of arthritis.

Chronic autoimmune conditions like inflammatory arthritis occur when the immune system

unintentionally attacks healthy body tissues and thinks they are infected with harmful germs.

Inflammation of the afflicted tissues in and around joints is the outcome.

Acute or chronic inflammatory arthritis can be caused by calcium pyrophosphate deposition

disease (CPPD), which is caused by calcium pyrophosphate dihydrate crystal deposition in

the synovial and periarticular tissues (Zamora et al., 2019). The term "pseudogout" is

typically used to describe acute CPPD arthritis since this synovitis resembles gout but is

caused by the deposition of monosodium urate crystals (Khan Academy, 2019). Pseudo-

rheumatoid arthritis that affects the wrists and metacarpophalangeal (MCP) joints and has a
waxing and waning clinical history that may linger for several months is known as chronic

CPPD (Zamora et al., 2019).

According to Zamora et al. (2019), CPPD is highly related to hyperparathyroidism and is also

thought to trigger inflammation and worsen soft tissue injuries. Most acute CPPD patients are

over 65, and between 30 and 50 percent of patients are over 85(Zamora et al., 2019). Joint

edema, erythema, stiffness, heat, discomfort, and even fever are all present in these people.

Radiography and synovial fluid studies can also be used to diagnose CPPD e.g., MRI and

ultrasound. When calcium pyrophosphate dihydrate crystals are aspirated from synovial fluid,

they are visible as rhomboid shapes under polarized microscopy, and "these crystals often

display positive birefringence" (Zamora et al., 2019). The monosodium urate crystal for

treating gout, in contrast, has the form of a needle.

Joint extraction, nonsteroidal anti-inflammatory medications (NSAIDs), and intra-articular

glucocorticoid injections are typically used as treatments for patients with acute CPPD to

reduce crystal deposition and inflammation (Zamora et al., 2019).

 Reference

1. OpenStax. (2018) Anatomy & physiology. Houston, TX: Rice University. Retrieved from:
https://cnx.org/contents/FPtK1zmh@12.6:fEI3C8Ot@16/Preface

2. Khan Academy. (2019) Retrieved from: https://www.khanacademy.org

3. Zamora EA, Naik R. Calcium Pyrophosphate Deposition Disease (CPDD) [Updated 2019 Mar 15]. In:
StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-. Retrieved from:
https://www.ncbi.nlm.nih.gov/books/NBK540151/