What Is Calcium Pyrophosphate Deposition Disease (CPPD)?

From Symptoms to Treatment

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Calcium pyrophosphate deposition disease (CPPD) is a type of arthritis. It is caused by deposits of calcium phosphate crystals in the joints and is similar to gouty arthritis (gout). A CPPD attack can happen unexpectedly and cause intense pain.

CPPD is known by other names as well. These include pseudogout, which is an older term that is still commonly used, and chondrocalcinosis, specifically referring to calcium deposits in the joint spaces.

 The acronym CPPD is sometimes mistaken for  COPD (Chronic Obstructive Pulmonary Disease), which is a disease that affects the lungs.

CPPD Attacks Increase With Age

Calcium deposits found in CPPD can trigger inflammatory arthritis and joint pain. The risk of a CPPD attack greatly increases with age.

According to the American College of Rheumatology, CPPD crystals are present in almost 3 percent of people in their 50s. That increases to nearly 50 percent as people reach their 90s. However, not everyone will experience symptoms.

CPPD attacks most often affect the knees. In some people, the pain may also affect the ankles, elbows, hands, wrists, and shoulders.

The attacks can be sudden and intense, lasting from a few days to two weeks and may be accompanied by a fever. For some people, CPPD may be triggered by a severe illness, surgery, or trauma.

How Is CPPD Diagnosed?

CPPD is often a delayed diagnosis because the symptoms are similar to and mistaken for other arthritic conditions including osteoarthritis (OA) and rheumatoid arthritis (RA).

CPPD can also be mistaken as gout. In gout, the crystal deposits are composed of uric acid, not calcium phosphate.

Proper diagnosis depends on analysis of the crystals found in the fluid of the affected joint. Your doctor may take an ultrasound, X-ray, or use another imaging method to determine if calcium deposits are visible.

In some cases, blood tests may be required as well.

Treatment Options for CPPD

Since CPPD is a different condition than gout, the treatment differs. However, there are some medications that are used to treat both conditions.

The important thing to know is that the crystal deposits cannot be dissolved. Therefore, your doctor will likely try to control the pain and prevent future attacks with anti-inflammatory medications. Prescription nonsteroidal anti-inflammatory drugs (NSAIDs) are common and can help control the pain and inflammation. Since some people—particularly those with kidney problems, stomach ulcers, and who are taking blood thinners—cannot take NSAIDs, other options are available.

A low dose of colchicine, which is commonly used in gout treatments, may be used to control attacks. Sometimes cortisone steroid shots are injected into the joint after it has been drained. In more severe cases, surgery may be recommended.

If CPPD is left untreated, it can further damage your cartilage and joints. For this reason, it's important to speak to your doctor or rheumatologist as soon as possible if you believe you're experiencing a CPPD attack or other unexpected arthritis symptoms.

Source: 

Barre L. Calcium Pyrophosphate Deposition (CPPD). American College of Rheumatology. 2017.

Schlee S, Bollheimer LC, Bersch T, Sieber CC, Harle P. Crystal Arthritides - Gout and Calcium Pyrophosphate Arthritis: Part 1: Epidemiology and Pathophysiology. Zeitschrift Fur Gerontologie Und Geriatrie. 2017 Feb 23. doi: 10.1007/s00391-017-1197-3.

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