Calcium pyrophosphate dihydrate deposition disease (chondrocalcinosis): a review.

Calcium pyrophosphate dihydrate deposition disease (CPPD) is a metabolic arthropathy characterized by gross calcium pyrophosphate crystals deposition within articular cartilage, in the periarticular and articular tissues. The disease is also called by other names such as pseudogout or chondrocalcinosis. Deposition of calcium pyrophosphate dihydrate crystals provokes an inflammation within the synovial membrane followed by degenerative changes in cartilage and bone. The underlying mechanism for increased intraarticular accumulation of calcium crystals is not known. CPPD is fairly common condition affecting mostly older people. It manifests in three clinical forms: asymptomatic (the most common), acute and chronic. Diagnosis is made on the basis of X-ray or ultrasound examination, but definitive confirmation requires demonstration of calcium pyrophosphate dihydrate crystals in the synovial fluid. Treatment of acute CPPD is similar to treatment of gout attack and consists in physical measures and medication with NSAIDs, colchicine or sometimes steroids. This review summarizes recent findings about the etiopathogenesis, diagnosis and management of CPPD.