chondrocalcinosis

Introduction

Calcification of fibrocartilage & hyaline articular cartilage.

Etiology

• pseudogout (CPPD disease)

Epidemiology

• 28% of elderly, ambulatory patients
• 44% of institutionalized elderly > 80 years of age
• 16% of elderly 80-89 with knee meniscal calcification
• 30% of elderly 89-99 with knee meniscal calcification
• > 90% of elderly with knee chondrocalcinosis have chondrocalcinosis elsewhere

Pathology

• deposition of calcium pyrophosphate dihydrate (CPPD) in synovial fluid, cartilage & periarticular soft tissue
• calcification of fibrocartilage & hyaline articular cartilage

Genetics

• familial forms associated with mutant ank-gene defects associated with ANKH gene (CCAL2) (autosomal dominant)

Clinical manifestations

• involvement of hands, wrists, pelvis &/or knees
• may present as arthritis or pseudoneuropathic pain
• may be asymptomatic

Laboratory

• serum Ca+2, serum phosphate, serum Mg+2
  • hypercalcemia, hypophosphatasia, hypomagnesemia
• complete blood count (CBC)
• iron studies: serum iron, TIBC, serum ferritin
• serum uric acid
• thyroid function testing

Radiology

• punctate &/or linear radiodensities in cartilage

Differential diagnosis

• pseudogout (CPPD disease)
• gout
• ochronosis
• hemochromatosis
• hyperparathyroidism
• hypothyroidism
• familial hypocalciuria
• trauma
• aging

Management

• see specific etiology or CPPD disease
• asymptomatic disease needs no treatment

More general terms

• crystalline arthritis (crytalline arthropathy)
• sign/symptom

Additional terms

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

Database

• OMIM: https://mirror.omim.org/entry/118600