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Pyrophosphate arthropathy, Chondrocalcinosis causes, diagnosis, treatment

Definition
It is a crystal deposition of calcium pyrophosphate dehydrate (CPPD) in cartilage (chondrocalcinosis). It is a common age associated phenomenon (>55) that particularly targets the knee .
Aetiology (Causes)
It is idiopathic, it can occur with certain metabolic diseases e.g hemochromatosis, Wilson's disease, hyperparathyroidism and chronic renal failure patients under regular hemodialysis .
Clinical picture 
There are different clinical patterns
1- Mono arthritis.                      
• Especially in the knee.          } Attacks of pseudogout
• Male = Female, old age.
2- Pseudo-rheumatoid arthritis with polyarthritis for months.

3- Pseudo-osteoarthritis.
4- Pseudo-neuropathic with severe destruction (charcot joint like) .
5- A symptomatic (common).

Diagnosis of Pyrophosphate arthropathy

X ray :  calcification of articular cartilage.
Pyrophosphate-arthropathy-Chondrocalcinosis

ESR +++  - CRP +++
TLC +++
• Examination of joint fluid crystals by polarizing microscopy.

Treatment

• NSAID
• Intra articular corticosteroids if indicated.
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Tamer Mobarak

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