Calcium pyruvate deposition disease, also known as CPDD or pseudogout, is associated with aging and rarely seen in individuals younger than 60-years-old. In this disease, calcium pyruvate crystals accumulate in your joint cartilage and migrate into your joint fluid where it causes an inflammatory reaction. The disease is most prevalent in your knees but the crystals can develop in other joints as well. Untreated CPDD can lead to permanent joint damage.
Symptoms and Diagnosis
Symptoms of CPDD include sudden, severe joint pain and the joint is usually warm to touch. Sometimes the skin around the joint is discolored red or purple and swelling occurs. These symptoms are common to other diseases such as gout, rheumatoid arthritis or osteoarthritis. It can be correctly diagnosed by a physician using joint fluid examination and X-ray technology. A microscopic examination of the joint fluid will identify calcium pyruvate crystals, while X-rays reveal calcium deposits within the tissues.
Causes
Calcium pyruvate crystals cause CPDD, though doctors do not know why the crystals form. The disease is associated with age, having close to 50 percent of men and women older than 80-years-old with crystal deposits in their joints, though many never ever experience any symptoms. A family history of CPDD, joint trauma and some medical conditions may cause an increased incidence of CPDD symptoms. Hereditary high iron storage disease, hyperparathyroidism and hypothyroidism are some conditions, which can explain CPDD in younger individuals.
Treatment Options
No cure is available for CPDD. Common treatment options include joint aspiration, anti-inflammatory medication, steroid medication and more invasive procedures. Most physicians treat CPDD by removing joint fluid to relieve pressure and then medicating the patient with non-steroidal anti-inflammatory medications, or NSAIDs. Severely inflamed joints may benefit from steroid injections directly into the joint. A low-dose of colchicines may be prescribed to provide relief for patients who don't tolerate NSAIDs.
Complications
An initial CPDD attack can last five to 12 days without treatment. As you age, the attacks may come more often, affect more joints and cause more intense pain. Untreated, repeat attacks cause joint damage. Bones in the affected joint can develop cysts, bone spurs and cartilage degradation. CPDD induced crumbling bone erosions may lead to total joint loss, which is followed by surgical replacement. Also, if crystals accumulate around spinal vertebrae, neurological symptoms may occur. No proven therapy works for every CPDD diagnosis, each treatment is tailored to the patient by appropriate medical personnel.
References
- MayoClinic.com; Pseudogout; April 2010
- The Cleveland Clinic: Pseudogout
- Medscape; Imaging in Calcium Pyrophosphate Deposition Disease; Bruce Rothschild; May 2011
- Arthritis Foundation: Calcium Pyrophosphate Dihydrate Crystal Deposition Disease
- National Institutes of Health; Pseudogout; Mark James Borigini; May 2010
