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chondrocalcinosis

Calcification of fibrocartilage & hyaline articular cartilage. Etiology: - pseudogout (CPPD disease) Epidemiology: 1) 28% of elderly, ambulatory patients 2) 44% of institutionalized elderly > 80 years of age 3) 16% of elderly 80-89 with knee meniscal calcification 4) 30% of elderly 89-99 with knee meniscal calcification 5) > 90% of elderly with knee chondrocalcinosis have chondrocalcinosis elsewhere Pathology: 1) deposition of calcium pyrophosphate dihydrate (CPPD) in synovial fluid, cartilage & periarticular soft tissue 2) calcification of fibrocartilage & hyaline articular cartilage Genetics: - familial forms associated with mutant ank-gene defects associated with ANKH gene (CCAL2) (autosomal dominant) Clinical manifestations: 1) involvement of hands, wrists, pelvis &/or knees 2) may present as arthritis or pseudoneuropathic pain 3) may be asymptomatic Laboratory: 1) serum Ca+2, serum phosphate, serum Mg+2 -> hypercalcemia, hypophosphatasia, hypomagnesemia 2) complete blood count (CBC) 3) iron studies: serum iron, TIBC, serum ferritin 4) serum uric acid 5) thyroid function testing Radiology: - punctate &/or linear radiodensities in cartilage Differential diagnosis: 1) pseudogout (CPPD disease) 2) gout 3) ochronosis 4) hemochromatosis 5) hyperparathyroidism 6) hypothyroidism 7) familial hypocalciuria 8) trauma 9) aging Management: 1) see specific etiology or CPPD disease 2) asymptomatic disease needs no treatment [5]

Related

ank-gene gout hemochromatosis ochronosis pseudogout [calcium pyrophosphate dihydrate crystal deposition] or CPPD disease

General

crystalline arthritis (crytalline arthropathy) sign/symptom

Database Correlations

OMIM 118600

References

  1. UCSF Introduction to Clinical Imaging, Radiology syllabus, 1993
  2. Journal Watch, Mass Med Soc 20(17):139 (Sept) 2000 Ho et al, Science 289:265, 2000 Hagman, Science 289:225, 2000
  3. Weiner, S in: Intensive Course in Geriatric Medicine & Board Review, Santa Monica, CA, Sept 20-23, 2000
  4. Weiner S, In: UCLA Intensive Course in Geriatric Medicine & Board Review, Marina Del Ray, CA, Sept 12-15, 2001
  5. Medical Knowledge Self Assessment Program (MKSAP) 16 American College of Physicians, Philadelphia 2012
  6. Rosenthal AK. Update in calcium deposition diseases. Curr Opin Rheumatol. 2007 Mar;19(2):158-62. PMID: 17278931