Calcium pyrophosphate dihydrate deposition disease (CPPD) is a build up of calcium crystals in the joints. These crystals cause inflammation in the joints, which causes arthritis like conditions known as:
Arthritis of the Knee
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It is not known what causes these calcium pyrophosphates to form. Genetics appear to play a role since it may run in families.
Older adults are at increased risk of getting CPPD. Other factors include:
In most cases, CPPD does not lead to symptoms. When symptoms occur, they may come and go in acute attacks called flare-ups. They may get worse over 6-24 hours and last for 5-12 days. The frequency of flare-ups may increase with age.
Pseudoosteoarthritis symptoms are the most common type, especially in the knee. Symptoms may be on both sides of the body, but are generally worse on one side. Pseudoosteoarthritis may cause:
Pseudogout symptoms occur more frequently in the knee, but can occur in other joints as well. There may be periods of time when there are no symptoms. Attacks of pseudogout may be spontaneous, or may be brought on by surgery or illness. Pseudogout may cause:
Pseudorheumatoid arthritis symptoms occur least frequently and affect both sides of the body. Pseudorheumatoid arthritis may cause:
You will be asked about your symptoms and medical history. A physical exam will be done. Tests can be used to diagnose CPPD, or to rule out other conditions.
Your bodily fluids may be tested. This can be done with:
Images may be needed of your bodily structures. This can be done with:
There is no cure for CPPD and nothing is available to dissolve the crystal deposits that already exist.
Treatment of CPPD is focused on managing the discomfort during flare-ups. Without treatment, the pain and discomfort of CPPD will go away on its own within days to weeks.
Talk with your doctor about the best treatment plan for you. Rest, ice, and elevation may help relieve some pain. Other treatment options may include:
Medication may help to decrease inflammation, pain, and stiffness. Medications may include:
Additional procedures may be needed if home care and medications are not effective. Additional procedures may include:
Steroids Injected into Joint
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American College of Rheumatology
National Institute of Arthritis and Musculoskeletal and Skin Diseases
Calcium pyrophosphate dihydrate deposition disease. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T114067/Calcium-pyrophosphate-dihydrate-deposition-disease. Updated July 1, 2016. Accessed September 29, 2016.
Calcium pyrophosphate dihydrate crystal deposition disease (CPPD) (Pseudogout). The Arthritis Foundation website. Available at: http://www.arthritis.org/about-arthritis/types/calcium-pyrophosphate-deposition-disease-cppd. Accessed May 12, 2016.
Calcium pyrophosphate deposition (CPPD) (formerly called pseudogout). American College of Rheumatology website. Available at: http://www.rheumatology.org/I-Am-A/Patient-Caregiver/Diseases-Conditions/Calcium-Pyrophosphate-Deposition-CPPD. Updated September 2013. Accessed May 12, 2016.
Pseudogout. Cleveland Clinic website. Available at: http://my.clevelandclinic.org/services/orthopaedics-rheumatology/diseases-conditions/hic-pseudogout. Accessed May 12, 2016.
4/24/2014 DynaMed's Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T114067/Calcium-pyrophosphate-dihydrate-deposition-disease: Wise JN, Weissman BN, et al. American College of Radiology (ACR) Appropriateness Criteria for chronic foot pain. Available at: http://www.acr.org/~/media/ACR/Documents/AppCriteria/Diagnostic/ChronicFootPain.pdf. Updated 2013. Accessed June 29, 2015.
Last reviewed May 2016 by Michael Woods, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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