What Is Chondrocalcinosis?

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Chondrocalcinosis, also known as calcium pyrophosphate deposition (CPPD) disease, is a condition in which calcium pyrophosphate crystals build up in the joints. The deposits cause irritation that lead to inflammation and cartilage damage. The symptoms can be similar to gout and other types of arthritis. According to the Arthritis Foundation, almost half of people 85 and older have chondrocalcinosis.

An X-ray showing osteoarthritis of the knee.
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CPPD Symptoms

Not everyone who develops calcium crystals in their joints will experience symptoms. When symptoms do occur, they usually affect the knees but can also involve the shoulders, wrists, elbows, ankles, hands, or other joints.

If you develop CPPD, you may have episodes that come on suddenly and last for days or weeks. CPPD is sometimes referred to as pseudogout because symptoms can sometimes be similar to gout. Also, joint inflammation can result in symptoms associated with osteoarthritis or rheumatoid arthritis including:

  • Pain and swelling in joints, especially shoulders, elbows, wrists, knuckles, knees, and ankles
  • Low-grade inflammation
  • Warm joints
  • Morning stiffness, fever, and fatigue
  • Decreased joint function

Causes

Most of the time, there is no known cause for CPPD. Developing CPPD is more likely as you age, although it can occur in young people, too. CPPD does tend to run in families, so genetics might play a role.

Other possible causes of chondrocalcinosis include:

  • Excess stores of iron (hemochromatosis)
  • Overactive parathyroid (hyperparathyroidism)
  • A severely underactive thyroid (hypothyroidism)
  • Low levels of magnesium in the blood (hypomagnesemia)
  • Excess calcium in the blood (hypercalcemia). 

Diagnosis

To diagnose CPPD, your doctor may use a needle to take fluid from your painful joint to look for calcium pyrophosphate crystals. They may also use diagnostic techniques such as X-rays, computerized tomography (CT) scans, and magnetic resonance imaging (MRI) that can visually detect the presence of crystal deposits. Blood tests may be performed to rule out other conditions.

Treatment

There are no medical techniques for dissolving or otherwise destroying or removing crystal deposits associated with chrondrocalcinosis. However, there are effective ways o relieve symptoms. For inflammation, swelling, and pain, your doctor may prescribe a nonsteroidal anti-inflammatory drug (NSAID) such as Indocin (indomethacin) or Naprosyn (naproxen).

When a joint affected by CPPD becomes extremely painful and swollen, your doctor may drain some of the built-up fluid by inserting a needle into the area. This might also remove some of the crystals from the joint. After that, a corticosteroid and a numbing medication can be injected into the joint to decrease inflammation and pain. Your doctor may also prescribe low doses of Colcrys (colchicine), a medication used primarily to prevent flare ups of gout.

For severe attacks or chronic inflammation, your doctor may prescribe medication such as Plaquenil (hydroxychloroquine), Trexall (methotrexate), or Kineret (anakinra). Surgery to replace damaged joints may also be an option in severe cases.

When caring for CPPD at home, you can try applying ice packs for short periods of time to help reduce pain and inflammation in the joints. Maintaining a healthy weight can also minimize stress on joints and reduce inflammation.

A Word From Verywell

If you’re experiencing joint pain or swelling, contact your doctor. Through tests and imaging, they can help determine if your pain is caused by CPPD. With medications and at-home care, you can usually manage symptoms and maintain joint function.

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  1. American College of Rheumatology. Calcium pyrophosphate deposition (CPPD). Updated March 2017.

  2. Arthritis Foundation. Calcium pyrophosphate deposition