Calcium pyrophosphate deposition disease Flashcards
What is CPPD associated with?
Advanced age, OA, hyperparathyroidism, haemochromatosis
How does CPPD present?
Acute crystal arthritis
Chronic inflammatory arthritis
OA with CPPD
How do you Dx CPPD?
Synovial fluid aspirate - CPP crystals
US
What are the synovial fluid findings?
Leukocytosis
Rhomboid or rod-shaped crystal - weakly positive berefringence
What are the X-ray findings?
Involvement at sites uncommon for OA eg MCP, wrists, elbows, shoulders
Chondrocalcinosis
Prominent osteophyte formation - hooked
What are the US findings?
Show double contour sign
Crystal deposition within hyaline articular cartilage
What’s Crowned dens syndrome?
Neck/shoulder girdle pain +/- meningism due to CPPD surrounding the odontoid process
How is acute CPPD flare managed?
Similar to gout
- NSAIDs, COX-2 inhibitors
- High dose prednisolone
- Intra-articular injecitons
What are prophylaxis options?
Low dose colchicine - 500microg daily or BD
Hydroxychloroquine or methotrexate
