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What is Calcium pyrophosphate deposition disease

Calcium pyrophosphate deposition disease is a type of crystal arthropathy, like gout. The term crystal arthropathy means that crystals of a chemical (like urate in gout, and calcium pyrophosphate in pseudogout) are precipitating and depositing in the joint, leading to inflammation.

In Calcium pyrophosphate deposition disease there is deposition of calcium pyrophosphate dihydrate (CPPD) crystals in the joint cartilage and the tissue around the joint. Shedding of the crystals into the joint produces an acute inflamed joint (like in gout) often refered to as pseudogout though pseudogout commonly involves the knee and wrist as opposed to gout which affects the big toe commonly. In pseudogout there can be gradual destruction of the joint as well.

Who gets it?

This condition commonly occurs in elderly women - patients are over 60.
It can occur in men as well.

Predisposing Factors

The cause of the condition is not known, though there are certain risk factors:

• dehydration
• intercurrent illness,
• hyperparathyrodism (causing increased calcium in the blood),
• myxoedema, diabetes mellitus,
• decreased phosphate or decreased magnesium,
• any arthritis,
• haemochromatosis,
• hyperthyroidism and
• gout.
  

Progression

There is no way to predict the course of the disease in a particular patient.

• In some recurrent acute attacks (as in gout but less severe) may be the norm with apparent normality between attacks.
• Other patients may progress and develop significant joint damage with impairment of function.
  
  

Probable Outcomes

• Some patients may progress and develop significant joint damage with impairment of function.
• Treatment may offer symptomatic relief, however, there is unfortunately no treatment for arresting the progress of the disease.
  
  

How is it diagnosed?

• Full blood count: - may show a raised white cell count
• Radiology: may show linear calcification parallel to the articular surfaces (in articular cartilage which is normally radiolucent - chondrocalcinosis)
• Serum calcium: normal.
  
  

How is it treated?

As mentioned before, no treatment will abolish the condition. Hence treatment is mainly symptomatic with:

• NSAIDs. (non-steroidal anti-inflammatory drugs)
• Colchicine may be used. (used to prevent or treat attacks of gout)
• Aspiration of the joint will often relieve pain; and
• If infection is excluded - a steroid injection into the joint will also help.

So at present there is no treatment to stop the disease. I had a flair up in late February and as i write this i am awake with a lot pain in my right knee and i can not straighten the blooming thing Anyone got a spare chainsaw.

JJ