![]() Less common forms of CPPD arthritis include pseudo-neuropathic joint disease with severe degenerative and destructive arthritis identical to that seen in diabetes and tabes dorsalis. The prevalence of asymptomatic CPPD arthritis increases significantly with age and may coexist with OA and other arthropathies. Most patients are diagnosed when radiographs reveal chondrocalcinosis or other typical findings of CPPD arthritis. It can produce slowly progressive joint degeneration which may be indistinguishable from osteoarthritis (OA), with bilateral involvement of many different joints including wrists, hips, knees, shoulders and elbows.Īsymptomatic arthritis is the fourth common form of CPPD arthritis. This condition has been named pseudo-osteoarthritis. Patients may have prominent inflammatory symptoms of morning stiffness and fatigue, but fever is rare.Īnother form of CPPD arthritis occurs when multiple joints are affected but inflammatory symptoms (such as morning stiffness) and inflammatory signs (synovitis) are lacking. ![]() Bilateral shoulder and knee involvement are also common and may be accompanied by muscle atrophy in longstanding cases. This may result in decreased flexion and extension. The wrists are characteristically affected with tenderness and synovial thickening (synovitis). Some patients develop pseudogout in multiple joints accompanied by fever and occasionally mental status changes, particularly in the elderly.Ĭhronic polyarticular CPPD arthritis can mimic rheumatoid arthritis (pseudo-rheumatoid arthritis.) The typical patient is an elderly female with a several month history of pain and swelling in multiple joints. Acute CPPD arthritis usually resolves spontaneously in one or two weeks and leaves no residual swelling or deformity. The knee is most commonly affected but any joint may be involved, including the first metatarsal joint (pseudopodagra.) The joint appears swollen, red, warm and tender and may have a large effusion. The patient is often an adult male with severe joint pain and swelling that reaches maximum intensity within hours. It may be precipitated by an injury, severe illness, or major surgery. Pseudogout is characterized by acute arthritis usually of one joint. Familial forms of CPPD arthritis are rare and involve a mutation of a membrane protein involved in phosphorus transport. Other conditions thought to be related to CPPD arthritis but with no proven association include hypothyroidism, gout, and Wilson’s disease. 3 It is particularly important to evaluate for hemochromatosis because early treatment will prevent cirrhosis even though it will not reverse the arthritis. Screening for these conditions should be considered in all patients but the yield is highest in young patients and in those with polyarticular disease. Patients with these diseases have an increased risk of developing CPPD arthritis. There are clear associations with hemochromatosis, primary hyperparathyroidism, and hypomagnesemia but the pathogenic mechanisms remain obscure. Osteoarthritis, joint trauma, and joint surgery are also risk factors.Īn important aspect of CPPD arthritis is its association with metabolic and endocrine disorders (See Table 1). 2 Male and female patients are affected equally. Up to 36% of patients older than 75 years have radiographic evidence of CPPD deposition (mainly chondrocalcinosis). For additional information visit Linking to and Using Content from MedlinePlus.The most important risk factor for the development of CPPD arthritis is aging. ![]() Any duplication or distribution of the information contained herein is strictly prohibited without authorization. Links to other sites are provided for information only - they do not constitute endorsements of those other sites. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. This site complies with the HONcode standard for trustworthy health information: verify here. Learn more about A.D.A.M.'s editorial policy editorial process and privacy policy. is among the first to achieve this important distinction for online health information and services. follows rigorous standards of quality and accountability. is accredited by URAC, for Health Content Provider (URAC's accreditation program is an independent audit to verify that A.D.A.M. ![]()
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