Pseudogout, chondrocalcinosis, CPPD et al: crystal clear… or clear as mud?-The time has come to reconsider the nomenclature of calcium pyrophosphate deposition.

Edoardo Cipolletta, Sara K Tedeschi, Emilio Filippucci, Silvia Sirotti, Nicola Dalbeth, Georgios Filippou, Antonella Adinolfi, Robert Terkeltaub, Tristan Pascart, Charlotte Jauffret, Daniele Cirillo, Luca Ingrao, Alessandro Lucia

Journal: Annals of the rheumatic diseases 2025;84(8):1287-1292

PMID: 40312208

Abstract

Scientific interest in calcium pyrophosphate deposition (CPPD) has been limited by several challenges. These include difficulties in diagnosis due to diverse clinical presentations, the lack of classification criteria, the absence of standardised diagnostic modalities, underrecognition in clinical care, and, most significantly, the lack of evidence-based treatments. Consequently, CPPD was often regarded as the 'poor cousin' of gout. Fortunately, in recent years, CPPD has garnered increased attention from the rheumatology community. Milestones such as the first American College of Rheumatology/European Alliance of Association for Rheumatology classification criteria, the European Alliance of Association for Rheumatology recommendations for the use of imaging in clinical practice, validated OMERACT ultrasound definitions and scoring system, and the OMERACT core domain sets for CPPD have significantly advanced the field. Yet, unresolved issues regarding CPPD nomenclature hold back advancement in both research and clinical practice. The terminology surrounding CPPD remains inconsistent in the scientific literature, with numerous terms and acronyms used to describe the condition and its manifestations. For example, many 'pseudosyndromes' (eg, pseudogout) and purely radiographic descriptors (eg, chondrocalcinosis) are still commonly used by clinicians and researchers interchangeably, as either the name of the condition or one of its clinical or radiographic manifestations. This lack of standardisation complicates communication among health care professionals, researchers, and between doctors and patients, creating insurmountable barriers to effective care and research advances. In this viewpoint, we highlight the value of standardised terminology, drawing parallels with other rheumatic diseases. We aimed to explore the historical evolution of CPPD nomenclature, assess the impact of previous standardisation efforts, and propose a possible way for a common language.

Copyright © 2025 The Authors. Published by Elsevier B.V. All rights reserved.

Address: Department of Rheumatology, IRCCS Galeazzi -Sant'Ambrogio Hospital, Milan, Italy; Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, Milan, Italy.; Rheumatology Department, Lille Catholic University, Saint Philibert Hospital, EA 7446 - ETHICS, Lille, France; University of Lille, ULR 2694 -METRICS, CERIM, Lille, France.; Rheumatology Unit, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy.; Rheumatology Unit, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, Ancona, Italy; Academic Rheumatology, University of Nottingham, Nottingham, UK.; Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy.; Rheumatology Unit, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, Ancona, Italy.; Rheumatology Department, Lille Catholic University, Saint Philibert Hospital, EA 7446 - ETHICS, Lille, France.; Division of Rheumatology, Inflammation and Immunity, Brigham and Women's Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA.; Department of Medicine, Division of Rheumatology, Autoimmunity, and Inflammation, University of California San Diego, La Jolla, CA, USA.; Department of Medicine, University of Auckland, Auckland, New Zealand.; Department of Rheumatology, IRCCS Galeazzi -Sant'Ambrogio Hospital, Milan, Italy; Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, Milan, Italy. Electronic address: [email protected].
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