Fact-sheet: Calcium pyrophosphate crystal deposition disease - Chondrocalcinosis
Updated on 04/23/2019 at 9:51 AM
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Definition
Microcrystalline arthropathy characterized by deposition of calcium pyrophosphate crystals in articular cartilage and fibrocartilage. 80% of cases are primary. May be familial, or caused by Hemochromatosis, Hyperparathyroidism, Hypophosphatasia, hypomagnesemia, or Bartter syndrome.
Clinical features
Usually subacute or chronic pain.
Acute form = pseudogout.
Radiography
Linear cartilage calcifications
Meniscal calcifications
Calcification of the triangular fibrocartilage complex
Calcification of the pubic symphysis
Distal calcifications
Osteoarthritis with suggestive topography: omarthrosis, scaphotrapezial osteoarthritis, lunocapitate joint space narrowing, selective narrowing of the 2nd-3rd MCP joints, patellofemoral osteoarthritis, involvement of the craniocervical junction (including crowned dens syndrome)
Possible significant subchondral erosions and destructive tendency
MRI
On MRI, cartilage calcifications appear as linear low signal intensity within the cartilage on all sequences.
The signal of meniscal calcifications is variable
Management
Treatment of acute flares:
Rest the joint
Evacuation puncture for pain relief of a large joint (Knee)
Icing of the joint area
Oral NSAIDs for 7 to 14 days
Differential diagnosis
Gout Primary Osteoarthritis