CALCIUM PYROPHOSPHATE DIHYDRATE (CPPD) CRYSTAL DEPOSITION DISEASE Pseudogout

Red, hot inflammed joint. Not uncommon in shoulder, or hip Red, hot inflammed joint. Not uncommon in shoulder, or hip. Poly articular fasion, mimic RA Lose joint sense Calcium crystal deposited in cartilage (major difference from gout, in bone and around soft tissues) May be asymptomatic except ca in cartilage Seen many in hospitalized pt p surgery

CPPD CRYSTAL DEPOSITION DISEASE: DISEASE ASSOCIATIONS Hyperparathyroidism Hemachromatosis – iron overload Osteoarthritis Hypomagnesemia Familial Hypophosphatasia Vast majority have osteoarth.

Osteoarthritic joints DIP Ca deposit in wrist. In cartilage

Ca deposit in mesisci of knee

Articular cart/linear deposit along head of humerous

Bony fragmentation of ankle joint

Dx seen with crystals under microscope Dx seen with crystals under microscope. Arrangement opposite of gout crystals

TREATMENT OF PSEUDOGOUT NSAIDS Intra-articular steroids PO colchicine prophylaxis Can quiet down acute episodes but no good way to limit recurrent attacks