Calcium Pyrophosphate Deposition (CPPD) Disease Questions & Answers

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6. Pritzker KP, Cheng PT, Renlund RC. Calcium pyrophosphate crystal deposition in hyaline cartilage. Ultrastructural analysis and implications for pathogenesis. J Rheumatol. 1988. 15(5):828-35. [QxMD MEDLINE Link].

7. Ryan LM, Wortmann RL, Karas B. Pyrophosphohydrolase activity and inorganic pyrophosphate content of cultured human skin fibroblasts. Elevated levels in some patients with calcium pyrophosphate dihydrate deposition disease. J Clin Invest. 1986 May. 77(5):1689-93. [QxMD MEDLINE Link].

8. Zaka R, Williams CJ. Genetics of chondrocalcinosis. Osteoarthritis Cartilage. 2005 Sep. 13(9):745-50. [QxMD MEDLINE Link].

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10. Williams CJ. The role of ANKH in pathologic mineralization of cartilage. Curr Opin Rheumatol. 2016 Mar. 28(2):145-51. [QxMD MEDLINE Link].

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13. Kleiber Balderrama C, Rosenthal AK, Lans D, Singh JA, Bartels CM. Calcium Pyrophosphate Deposition Disease and Associated Medical Comorbidities: A National Cross-Sectional Study of US Veterans. Arthritis Care Res (Hoboken). 2017 Sep. 69 (9):1400-1406. [QxMD MEDLINE Link]. [Full Text].

14. McCarty DJ. Calcium pyrophosphate dihydrate crystal deposition disease--1975. Arthritis Rheum. 1976 May-Jun. 19 Suppl 3:275-85. [QxMD MEDLINE Link].

15. Paalanen K, Rannio K, Rannio T, Asikainen J, Hannonen P, Sokka T. Prevalence of calcium pyrophosphate deposition disease in a cohort of patients diagnosed with seronegative rheumatoid arthritis. Clin Exp Rheumatol. 2020 Jan-Feb. 38 (1):99-106. [QxMD MEDLINE Link]. [Full Text].

16. Duran Tİ, Özgen M. Two cases of calcium pyrophosphate deposition disease (CPPD) presented with spondylodiscitis. Eur J Rheumatol. 2020 Apr. 7 (2):84-87. [QxMD MEDLINE Link].

17. Kudoh K, Kudoh T, Tsuru K, Miyamoto Y. A case of tophaceous pseudogout of the temporomandibular joint extending to the base of the skull. Int J Oral Maxillofac Surg. 2017 Mar. 46 (3):355-359. [QxMD MEDLINE Link].

18. Park HJ, Chung HW, Oh TS, Lee JS, Song JS, Park YK. Tumoral pseudogout of the proximal interphalangeal joint of a finger: a case report and literature review. Skeletal Radiol. 2016 Jul. 45 (7):1007-12. [QxMD MEDLINE Link].

19. Watanabe K, Yamazaki Y, Sugawara M. Tuberculosis of the Wrist Accompanied with Calcium Pyrophosphate: A Case Report. Intern Med. 2017 Oct 11. [QxMD MEDLINE Link].

20. Bell DJ, Gaillard F, et al. Crowned dens syndrome. Radiopaedia. Available at https://radiopaedia.org/articles/crowned-dens-syndrome?lang=us. August 15, 2022; Accessed: April 5, 2023.

21. Haikal A, Everist BM, Jetanalin P, Maz M. Cervical CT-Dependent Diagnosis of Crowned Dens Syndrome in Calcium Pyrophosphate Dihydrate Crystal Deposition Disease. Am J Med. 2020 Feb. 133 (2):e32-e37. [QxMD MEDLINE Link].

22. Wold A, Petscavage-Thomas J, Walker EA. Non-union rate of type II and III odontoid fractures in CPPD versus a control population. Skeletal Radiol. 2018 Nov. 47 (11):1499-1504. [QxMD MEDLINE Link].

23. Zabotti A, Della Siega P, Picco L, Quartuccio L, Bassetti M, De Vita S. Gitelman syndrome disclosed by calcium pyrophosphate deposition disease: early diagnosis by ultrasonographic study. Reumatismo. 2016 Jun 23. 68(1):53-5. [QxMD MEDLINE Link].

24. Ryan LM. Calcium pyrophosphate dihydrate crystal deposition. Weyand CM, Wortman R, Klippel JH, eds. Primer on Rheumatic Diseases. 11th ed. Atlanta, Ga: Arthritis Foundation; 1997. 226-9.

25. Tedeschi SK, Becce F, Pascart T, Guermazi A, Budzik JF, Dalbeth N, et al. Imaging Features of Calcium Pyrophosphate Deposition Disease: Consensus Definitions From an International Multidisciplinary Working Group. Arthritis Care Res (Hoboken). 2023 Apr. 75 (4):825-834. [QxMD MEDLINE Link].

26. Mitton-Fitzgerald E, Gohr CM, Williams CM, Rosenthal AK. Identification of Common Pathogenic Pathways Involved in Hemochromatosis Arthritis and Calcium Pyrophosphate Deposition Disease: a Review. Curr Rheumatol Rep. 2022 Feb. 24 (2):40-45. [QxMD MEDLINE Link].

27. Radu L, Groppa L, Vudu L. MUSCULOSKELETAL IMPAIRMENT IN PRYMARY HYPOTHYROIDISM. Rev Med Chir Soc Med Nat Iasi. 2016 Apr-Jun. 120 (2):244-51. [QxMD MEDLINE Link].

28. Zeng C, Wei J, Terkeltaub R, Yang T, Choi HK, Wang YL, et al. Dose-response relationship between lower serum magnesium level and higher prevalence of knee chondrocalcinosis. Arthritis Res Ther. 2017 Oct 24. 19 (1):236. [QxMD MEDLINE Link].

29. Boumans D, Hettema ME, Vonkeman HE, Maatman RG, van de Laar MA. The added value of synovial fluid centrifugation for monosodium urate and calcium pyrophosphate crystal detection. Clin Rheumatol. 2017 Jul. 36 (7):1599-1605. [QxMD MEDLINE Link].

30. Niessink T, Otto C, Janssen M, Jansen TL. Calcium carbonates are novel positive birefringent crystals in synovial fluid. Clin Rheumatol. 2023 Feb. 42 (2):635-636. [QxMD MEDLINE Link]. [Full Text].

31. Jacques T, Michelin P, Badr S, Nasuto M, Lefebvre G, Larkman N, et al. Conventional Radiology in Crystal Arthritis: Gout, Calcium Pyrophosphate Deposition, and Basic Calcium Phosphate Crystals. Radiol Clin North Am. 2017 Sep. 55 (5):967-984. [QxMD MEDLINE Link].

32. Saffar P. Chondrocalcinosis of the wrist. J Hand Surg [Br]. 2004 Oct. 29(5):486-93. [QxMD MEDLINE Link].

33. Ellabban AS, Kamel SR, Omar HA, El-Sherif AM, Abdel-Magied RA. Ultrasonographic diagnosis of articular chondrocalcinosis. Rheumatol Int. 2011 Dec 23. [QxMD MEDLINE Link].

34. Gutierrez M, Di Geso L, Salaffi F, Carotti M, Girolimetti R, De Angelis R, et al. Ultrasound detection of cartilage calcification at knee level in calcium pyrophosphate deposition disease. Arthritis Care Res (Hoboken). 2014 Jan. 66(1):69-73. [QxMD MEDLINE Link].

35. Filippou G, Adinolfi A, Iagnocco A, Filippucci E, Cimmino MA, Bertoldi I, et al. Ultrasound in the diagnosis of calcium pyrophosphate dihydrate deposition disease. A systematic literature review and a meta-analysis. Osteoarthritis Cartilage. 2016 Jun. 24(6):973-81. [QxMD MEDLINE Link].

36. Expert Panel on Musculoskeletal Imaging:., Jacobson JA, Roberts CC, Bencardino JT, Appel M, Arnold E, et al. ACR Appropriateness Criteria^® Chronic Extremity Joint Pain-Suspected Inflammatory Arthritis. J Am Coll Radiol. 2017 May. 14 (5S):S81-S89. [QxMD MEDLINE Link].

37. Forien M, Combier A, Gardette A, Palazzo E, Dieudé P, Ottaviani S. Comparison of ultrasonography and radiography of the wrist for diagnosis of calcium pyrophosphate deposition. Joint Bone Spine. 2017 Sep 28. [QxMD MEDLINE Link].

38. Filippou G, Adinolfi A, Cimmino MA, Scirè CA, Carta S, Lorenzini S, et al. Diagnostic accuracy of ultrasound, conventional radiography and synovial fluid analysis in the diagnosis of calcium pyrophosphate dihydrate crystal deposition disease. Clin Exp Rheumatol. 2016 Mar-Apr. 34 (2):254-60. [QxMD MEDLINE Link].

39. Cipolletta E, Smerilli G, Mirza RM, Matteo AD, Carotti M, Salaffi F, et al. Sonographic assessment of calcium pyrophosphate deposition disease at wrist. A focus on the dorsal scapho-lunate ligament. Joint Bone Spine. 2020 May 10. [QxMD MEDLINE Link].

40. Filippou G, Filippucci E, Mandl P, Abhishek A. A critical review of the available evidence on the diagnosis and clinical features of CPPD: do we really need imaging?. Clin Rheumatol. 2020 Nov 24. [QxMD MEDLINE Link].

41. Magarelli N, Amelia R, Melillo N, Nasuto M, Cantatore F, Guglielmi G. Imaging of chondrocalcinosis: calcium pyrophosphate dihydrate (CPPD) crystal deposition disease -- imaging of common sites of involvement. Clin Exp Rheumatol. 2012 Jan-Feb. 30 (1):118-25. [QxMD MEDLINE Link].

42. Parperis K, Papachristodoulou E, Kakoullis L, Rosenthal AK. Management of calcium pyrophosphate crystal deposition disease: A systematic review. Semin Arthritis Rheum. 2021 Feb. 51 (1):84-94. [QxMD MEDLINE Link].

43. Andrés M, Sivera F, Pascual E. Therapy for CPPD: Options and Evidence. Curr Rheumatol Rep. 2018 Apr 19. 20 (6):31. [QxMD MEDLINE Link].

44. Abhishek A, Doherty M. Update on calcium pyrophosphate deposition. Clin Exp Rheumatol. 2016 Jul-Aug. 34 (4 Suppl 98):32-8. [QxMD MEDLINE Link].

45. Iqbal SM, Qadir S, Aslam HM, Qadir MA. Updated Treatment for Calcium Pyrophosphate Deposition Disease: An Insight. Cureus. 2019 Jan 7. 11 (1):e3840. [QxMD MEDLINE Link].

46. Meng Z, Baker DG, Branigan P, et al. Hydroxychloroquine inhibits matrix metalloprotease activity in experimental calcium pyrophosphate dihydrate (CPPD) crystal induced inflammation in the rat subcutaneous air pouch. Inflammopharmacology. 2000. 8:113-121. [Full Text].

47. Ea HK, Liote F. Calcium pyrophosphate dihydrate and basic calcium phosphate crystal-induced arthropathies: update on pathogenesis, clinical features, and therapy. Curr Rheumatol Rep. 2004 Jun. 6(3):221-7. [QxMD MEDLINE Link].

48. Announ N, Palmer G, Guerne PA, Gabay C. Anakinra is a possible alternative in the treatment and prevention of acute attacks of pseudogout in end-stage renal failure. Joint Bone Spine. 2009 Jul. 76(4):424-6. [QxMD MEDLINE Link].

49. Ottaviani S, Brunier L, Sibilia J, Maurier F, Ardizzone M, Wendling D, et al. Efficacy of anakinra in calcium pyrophosphate crystal-induced arthritis: a report of 16 cases and review of the literature. Joint Bone Spine. 2013 Mar. 80(2):178-82. [QxMD MEDLINE Link].

50. Moltó A, Ea HK, Richette P, Bardin T, Lioté F. Efficacy of anakinra for refractory acute calcium pyrophosphate crystal arthritis. Joint Bone Spine. 2012 Dec. 79(6):621-3. [QxMD MEDLINE Link].

51. Cipolletta E, Di Matteo A, Scanu A, Isidori M, Di Battista J, Punzi L, et al. Biologics in the treatment of calcium pyrophosphate deposition disease: a systematic literature review. Clin Exp Rheumatol. 2020 Apr 28. [QxMD MEDLINE Link].

52. Andrés M, Sivera F, Pascual E. Therapy for CPPD: Options and Evidence. Curr Rheumatol Rep. 2018 Apr 19. 20 (6):31. [QxMD MEDLINE Link].

53. Latourte A, Ea HK, Frazier A, Blanchard A, Lioté F, Marotte H, et al. Tocilizumab in symptomatic calcium pyrophosphate deposition disease: a pilot study. Ann Rheum Dis. 2020 Aug. 79 (8):1126-1128. [QxMD MEDLINE Link].

Constantine K Saadeh, MD President, Allergy ARTS, LLP; Principal Investigator, Amarillo Center for Clinical Research, Ltd

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Nicole Davey-Ranasinghe, MD Rheumatologist, Allergy ARTS, LLP, Amarillo Center for Clinical Research, Ltd

Nicole Davey-Ranasinghe, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians, American College of Rheumatology

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Herbert S Diamond, MD Visiting Professor of Medicine, Division of Rheumatology, State University of New York Downstate Medical Center; Chairman Emeritus, Department of Internal Medicine, Western Pennsylvania Hospital

Herbert S Diamond, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians, American College of Rheumatology, American Medical Association, Phi Beta Kappa

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Neil J Barkin, MD, FAAOS Consulting Surgeon, Capitol Orthopaedics & Rehabilitation, LLC

Neil J Barkin, MD, FAAOS is a member of the following medical societies: American Academy of Orthopaedic Surgeons

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Lawrence H Brent, MD Associate Professor of Medicine, Jefferson Medical College of Thomas Jefferson University; Chair, Program Director, Department of Medicine, Division of Rheumatology, Albert Einstein Medical Center

Lawrence H Brent, MD is a member of the following medical societies: American Association for the Advancement of Science, American Association of Immunologists, American College of Physicians, and American College of Rheumatology

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Paul E Di Cesare, MD, FACS Professor, Department of Orthopedic Sugery, University of California, Davis, School of Medicine

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Kristine M Lohr, MD, MS Professor, Department of Internal Medicine, Center for the Advancement of Women's Health and Division of Rheumatology, Director, Rheumatology Training Program, University of Kentucky College of Medicine

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Acknowledgments

The authors wish to thank Shannon Shaw and Michael Gaylor for their hard work in helping to prepare this article.

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