Calcium Pyrophosphate Deposition Disease 712.2

 

synonyms: calcium pyrophosphate deposition disease, CPPD, pseudogout, podagra, crystaline deposition disease

Pseudogout ICD-9

  • 712.2(chondrocalcinosis due to pyrophosphate crystals, site unspecified)
  • 712.21 (shoulder region)
  • 712.22 (upper arm)
  • 712.23 (forearm)
  • 712.24 (hand)
  • 712.25 (pelvic region and thigh)
  • 712.26 (leg)
  • 712.27 (ankle and foot)
  • 712.28 (other specified site)
  • 727.82 (calcium deposites in tendon and bursa)
  • 712.3 Chondrocalcinosis, unspecified
  • 275.4 Disorders fo calcium metabolism

Pseudogout Etiology / Epidemiology / Natural History

  • Caused by calcium pyrophosphate deposition in joints.
  • May lead to scapholunate advanced collapse in the wrist.
  • Chondrocalcinosis = calcification of the articular cartilage or meniscus. Usually occurs in the periphery. More common in women. Incidence increases with age.

Pseudogout Anatomy

  • May affect any joint: 50% occurs in the knees. Generally occurs in larger joints. sternoclavicular joints etc.

Pseudogout Clinical Evaluation

  • Acute severe pain in a single joint without antecedent trauma.
  • Pain, warmth, tenderness, erythema of affected joint.

Pseudogout Xray / Diagnositc Tests

  • Xrays: demonstrate chondrocalcinosis of the menisci or articular cartilage.
  • Joint aspiration: Fluid sent for cell count, gram stain and cultures. Calcium pyrophosphate crystals are weakly positive birefringent rhomboid-shaped crystals.

Pseudogout Classification / Treatment

  • Consider NSAIDs and corticosteroid injections.
  • Exercise, weight loss and canes may be beneficial

Pseudogout Associated Injuries / Differential Diagnosis

  • Associated with: hyperparathyroidism, hemochromatosis, hypophosphatasia and hypothyroidism
  • Gout
  • Osteoarthritis
  • Rheumatoid arthritis
  • Charcot arthropathy
  • Cellutis
  • Septic Joint
  • Lyme disease

Pseudogout Complications

  • Recurrence

Follow-up Care

  • Generally managed by PCP/rheumatologist long-term.

Pseudogout Review References

  • Fisseler-Eckhoff, Arthoscopy 1992;8:98.
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