[Chondrocalcinosis and calcium pyrophosphate (CPP) crystal deposition disease in 2010].

Rev Med Suisse

Service de rhumatologie, Département de médecine, HUG, 1211 Genève 14.

Published: March 2010

Chondrocalcinosis may be asymptomatic or take three classical forms (acute recurrent inflammatory, chronic inflammatory, with osteoarthritis). Apart form that, CPP crystal arthropathies can mimic several rheumatic diseases, including polymyalgia, septic arthritis and spondylodiscitis. Several conditions can predispose to chondrocalcinosis, including hemochromatosis, hyperparathyroidism, familial hypocalciuric hypercalcemia, hypomagnesemia and treatment with tacrolimus or diuretics. The diagnostic sensitivity of ultrasound seems better than radiography and CT is useful in spinal forms but whenever possible, the identification of crystals in synovial fluid remains essential. NSAIDs and/or glucocorticoids are frequently sufficient to control symptoms but methotrexate, at anti-inflammatory doses (10-20 mg/wk) appears useful in refractory forms.

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