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  • CPPD Atf

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    Omran Azzam
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    Calcium pyrophosphate deposition disease (CPPD) is characterized by calcium pyrophosphate crystal deposits in the joints and connective tissue. It typically affects older adults and presents as asymptomatic chondrocalcinosis seen on imaging, acute arthritis attacks similar to gout, or progressive joint degeneration resembling osteoarthritis. CPPD has no known cause but can be associated with conditions like joint trauma, hyperparathyroidism, and hemochromatosis. Treatment involves glucocorticoids, NSAIDs, or colchicine depending on whether symptoms are acute or chronic.

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    Calcium pyrophosphate deposition disease (CPPD) is characterized by calcium pyrophosphate crystal deposits in the joints and connective tissue. It typically affects older adults and presents as asymptomatic chondrocalcinosis seen on imaging, acute arthritis attacks similar to gout, or progressive joint degeneration resembling osteoarthritis. CPPD has no known cause but can be associated with conditions like joint trauma, hyperparathyroidism, and hemochromatosis. Treatment involves glucocorticoids, NSAIDs, or colchicine depending on whether symptoms are acute or chronic.

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    © All Rights Reserved
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    1 views11 pages

    CPPD Atf

    Uploaded by

    Omran Azzam
    Calcium pyrophosphate deposition disease (CPPD) is characterized by calcium pyrophosphate crystal deposits in the joints and connective tissue. It typically affects older adults and presents as asymptomatic chondrocalcinosis seen on imaging, acute arthritis attacks similar to gout, or progressive joint degeneration resembling osteoarthritis. CPPD has no known cause but can be associated with conditions like joint trauma, hyperparathyroidism, and hemochromatosis. Treatment involves glucocorticoids, NSAIDs, or colchicine depending on whether symptoms are acute or chronic.

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    of 11

    AfraTafreeh.

    com

    CPPD
    Jason Ryan, MD, MPH
    CPPD
    Calcium Pyrophosphate Deposition Disease

    • Calcium pyrophosphate deposition


    • Affects joints and connective tissue
    • Cause unknown

    AfraTafreeh.com

    Uric Acid Pyrophosphate


    AfraTafreeh.com

    CPPD
    Calcium Pyrophosphate Deposition Disease

    • Occurs in older patients


    • Average age: 72-years-old
    • Men = women
    • Clinical features
    • Asymptomatic (discovered on imaging)
    • Acute arthritis (similar to gout)
    • Chronic joint disease (similar to OA)
    Asymptomatic CPPD
    • Most joints with CPPD have no symptoms
    • Crystal deposits discovered on imaging
    • Chondrocalcinosis: calcification of hyaline cartilage

    AfraTafreeh.com

    Public Domain
    AfraTafreeh.com

    Pseudogout
    • Acute attacks of arthritis
    • Resemble attacks of gout: pseudogout
    • Knee involved in 50% of cases
    • Pain, redness, warmth, swelling

    James Heilman, MD/Wikipedia


    Pseudogout
    • Provoked by trauma, surgery, medical illness
    • Many flares reported after parathyroidectomy

    AfraTafreeh.com

    Wikipedia/Public Domain
    AfraTafreeh.com

    Pseudogout
    Polarized Light Microscopy

    • Rhomboid crystals
    • Positively birefringent
    • Blue when parallel to light (yellow for gout)

    Harriet Ribbons/Caroline Hoernig


    Chronic Joint Disease
    • Pseudo-osteoarthritis
    • Progressive joint degeneration
    • Occurs in ~50% of patients with CPPD joints
    • Progressive cartilage deterioration
    AfraTafreeh.com
    • Bony enlargement, tenderness similar to OA
    AfraTafreeh.com

    CPPD
    Treatment

    • Acute pseudogout attack


    • Intraarticular glucocorticoid injection
    • NSAIDs
    • Colchicine
    • Prophylaxis for pseudogout: Colchicine
    • Chronic joint disease: same treatment as OA
    CPPD
    Associated Conditions

    • Joint trauma
    • Hyperparathyroidism
    • Hemochromatosis

    AfraTafreeh.com
    AfraTafreeh.com

    Hemochromatosis
    • Hereditary iron overload disorder
    • Arthritis: common in hemochromatosis
    • Iron deposition in synovial tissue
    • Calcium pyrophosphate may also deposit
    • Seen in 2/3 of patients

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