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European Journal of Rheumatology Apr 2020Calcium pyrophosphate deposition disease (CPPD) is a crystal arthropathy, and may present with various clinical manifestations such as asymptomatic CPPD, osteoarthritis... (Review)
Review
Calcium pyrophosphate deposition disease (CPPD) is a crystal arthropathy, and may present with various clinical manifestations such as asymptomatic CPPD, osteoarthritis with CPPD, acute CPPD crystal arthritis (formerly pseudogout), and chronic CPPD crystal inflammatory arthritis. It is known that aging, trauma and osteoarthritis are major risk factors for CPPD. Acute CPP arthritis may occur as monoarticular or oligoarticular and usually involves large peripheral joints such as the knees, wrists and ankles. CPPD is characterized by sudden onset of severe pain, swelling and periarticular erythema, and systemic symptoms such as fever, chills, and weakness may occur. On the other hand, axial CPPD has been reported rarely and most cases appear with symptoms related to a mass effect such as foramen magnum syndrome, spinal stenosis, radiculopathy, myelopathy, synovial cyst or cauda equina syndrome. In addition, there are fewer reported cases of spinal CPPD that cause neck and back pain. This clinical condition should be considered in the differential diagnosis of acute neck and back pain.
PubMed: 32644929
DOI: 10.5152/eurjrheum.2020.19180 -
Radiology Case Reports Apr 2023Calcium pyrophosphate deposition involves deposition of calcium pyrophosphate dihydrate crystals in various joints throughout the body. The term "pseudogout" refers to...
Calcium pyrophosphate deposition involves deposition of calcium pyrophosphate dihydrate crystals in various joints throughout the body. The term "pseudogout" refers to an acute attack of calcium pyrophosphate crystal-induced arthritis. Though clinical presentation and joint involvement vary, involvement of the lumbar spine is rare. We present the case of a 61-year-old male who presented with 3 days of worsening lower back pain. He had elevated inflammatory markers, leukocytosis, and spinal tenderness on exam. Magnetic resonance imaging of the lumbar spine showed likely L4-L5 osteomyelitis; however, biopsy of the disk space revealed extensive calcium pyrophosphate crystal deposition. The patient was treated with prednisone taper with alleviation of symptoms. Though pseudogout of the spine is rare, our report supports literature urging clinicians to consider pseudogout when assessing elderly patients with back pain for prompt and appropriate treatment.
PubMed: 36747909
DOI: 10.1016/j.radcr.2022.10.057 -
Canadian Medical Association Journal Mar 1964
Topics: Adrenal Cortex Hormones; Calcification, Physiologic; Cartilage; Chondrocalcinosis; Crystallography; Diphosphates; Gout; Humans; Joint Diseases; Phenylbutazone; Synovitis
PubMed: 14127387
DOI: No ID Found -
British Medical Journal Oct 1964
Topics: Chondrocalcinosis; Humans; Pathology
PubMed: 14185646
DOI: 10.1136/bmj.2.5414.889 -
Osteoarthritis and Cartilage Sep 2005Rapid developments in genetic analysis have enabled the dissection of a variety of arthropathies that are inherited in a Mendelian manner. These disorders include... (Review)
Review
Rapid developments in genetic analysis have enabled the dissection of a variety of arthropathies that are inherited in a Mendelian manner. These disorders include calcium crystal arthropathies such as calcium pyrophosphate dihydrate deposition (CPPD) disease and hydroxyapatite deposition disease. In CPPD disease, mutations in a recently discovered gene, ANKH, have been demonstrated in five affected families and may also be associated with the idiopathic deposition of calcium pyrophosphate dihydrate crystals. The product of ANKH appears to be involved in cellular transport of inorganic pyrophosphate (PPi) and mutations in ANKH have been shown to have a significant impact on the regulation of intra- and extracellular levels of PPi. In families with hydroxyapatite deposition disease, no gene locus has yet been linked to the disorder.
Topics: Animals; Chondrocalcinosis; Genes, Recessive; Genetic Predisposition to Disease; Humans; Hydroxyapatites; Joints; Linkage Disequilibrium; Membrane Proteins; Mice; Models, Animal; Phenotype; Phosphate Transport Proteins
PubMed: 15951203
DOI: 10.1016/j.joca.2005.04.006 -
Rheumatic Diseases Clinics of North... May 2014Crystal arthropathies are among the most common causes of painful inflammatory arthritis. Gout, the most common example, has been associated with cardiovascular and... (Review)
Review
Crystal arthropathies are among the most common causes of painful inflammatory arthritis. Gout, the most common example, has been associated with cardiovascular and renal disease. In recent years, evidence for these associations and those involving other comorbidities, such as the metabolic syndrome, have emerged, and the importance of asymptomatic hyperuricemia has been established. In this review, an update on evidence, both experimental and clinical, is presented, and associations between hyperuricemia, gout, and several comorbidities are described. Causality regarding calcium pyrophosphate arthropathy and associated comorbidities is also reviewed.
Topics: Acute Kidney Injury; Cardiovascular Diseases; Cerebrovascular Disorders; Chondrocalcinosis; Comorbidity; Coronary Disease; Diabetes Mellitus; Gout; Heart Failure; Humans; Hypertension; Hyperuricemia; Metabolic Syndrome; Neurodegenerative Diseases; Osteoarthritis; Renal Insufficiency, Chronic
PubMed: 24703346
DOI: 10.1016/j.rdc.2014.01.005 -
Best Practice & Research. Clinical... Mar 2023Synovial fluid analysis can provide a prompt and definite diagnosis of crystal-induced arthritis, the most common acute inflammatory arthritis and a cause of chronic... (Review)
Review
Synovial fluid analysis can provide a prompt and definite diagnosis of crystal-induced arthritis, the most common acute inflammatory arthritis and a cause of chronic arthritis that may mimic rheumatoid, psoriatic, or peripheral spondyloarthritis. In many patients the diagnosis of gout or calcium pyrophosphate arthritis cannot be made with certainty without synovial fluid analysis. Additional information from fluid analysis can assist the clinician in honing the differential diagnosis of non-crystalline arthritis.
Topics: Humans; Synovial Fluid; Uric Acid; Gout; Chondrocalcinosis; Calcium Pyrophosphate
PubMed: 37429800
DOI: 10.1016/j.berh.2023.101848 -
Canadian Medical Association Journal Dec 1969
Topics: Calcinosis; Cartilage Diseases; Diagnosis, Differential; Gout; Humans
PubMed: 5364640
DOI: No ID Found -
Reumatismo Dec 2023The prevalence of crystal arthropathies in the general population is rising. The purpose of this pictorial study is to describe the sonographic elements of the most... (Review)
Review
OBJECTIVE
The prevalence of crystal arthropathies in the general population is rising. The purpose of this pictorial study is to describe the sonographic elements of the most prevalent crystal arthropathies by emphasizing particular sonographic findings using illustrative images and cases while considering technical details and common pitfalls.
METHODS
Using established recommendations, specialists in the fields of sonography and crystal arthropathies agreed by consensus on the unique ultrasound signs associated with each of the conditions.
RESULTS
Gout, calcium pyrophosphate deposition arthropathy, and hydroxyapatite arthropathy are the three most prevalent crystal arthropathies. Today's high-resolution sonography enables reliable evaluation of the underlying crystal deposits, post-inflammatory changes, and a precise description of joint inflammation.
CONCLUSIONS
High-prevalence crystal arthropathies are reliably detectable by ultrasound with current ultrasound equipment. It is necessary to have extensive ultrasound training, know specific sonographic findings, and understand all possible differential diagnoses for disorders affecting the musculoskeletal system.
Topics: Humans; Calcium Pyrophosphate; Chondrocalcinosis; Crystal Arthropathies; Gout; Ultrasonography
PubMed: 38115778
DOI: 10.4081/reumatismo.2023.1583 -
Arthritis & Rheumatology (Hoboken, N.J.) Aug 2018Calcium pyrophosphate (CPP) crystal deposition (CPPD) is prevalent and can be associated with synovitis and joint damage. The population of elderly persons predominantly... (Review)
Review
Calcium pyrophosphate (CPP) crystal deposition (CPPD) is prevalent and can be associated with synovitis and joint damage. The population of elderly persons predominantly affected by CPPD is growing rapidly. Since shortfalls exist in many aspects of CPPD, we conducted an anonymous survey of CPPD unmet needs, prioritized by experts from the Gout, Hyperuricemia and Crystal-Associated Disease Network. We provide our perspectives on the survey results, and we propose several CPPD basic and clinical translational research pathways. Chondrocyte and cartilage culture systems for generating CPP crystals in vitro and transgenic small animal CPPD models are needed to better define CPPD mechanism paradigms and help guide new therapies. CPPD recognition, clinical research, and care would be improved by international consensus on CPPD nomenclature and disease phenotype classification, better exploitation of advanced imaging, and pragmatic new point-of-care crystal analytic approaches for detecting CPP crystals. Clinical impacts of CPP crystals in osteoarthritis and in asymptomatic joints in elderly persons remain major unanswered questions that are rendered more difficult by current inability to therapeutically limit or dissolve the crystal deposits and assess the consequent clinical outcome. Going forward, CPPD clinical research studies should define clinical settings in which articular CPPD does substantial harm and should include analyses of diverse clinical phenotypes and populations. Clinical trials should identify the best therapeutic targets to limit CPP crystal deposition and associated inflammation and should include assessment of intraarticular agents. Our perspective is that such advances in basic and clinical science in CPPD are now within reach and can lead to better treatments for this disorder.
Topics: Aged; Animals; Chondrocalcinosis; Female; Gout; Health Services Needs and Demand; Humans; Hyperuricemia; Joint Diseases; Male; Middle Aged; Translational Research, Biomedical
PubMed: 29609209
DOI: 10.1002/art.40517