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ULY CLINIC
ULY CLINIC
20 Oktoba 2026, 12:37:49
Calcium pyrophosphate deposition disease (pseudogout)
20 Oktoba 2026, 12:37:49
Acute arthritis (knees, wrists, shoulders) mimicking gout or infection; chronic OA/RA-like form; chondrocalcinosis; crowned dens syndrome (neck pain, fever); linked to hyperparathyroidism and haemochromatosis.
Investigations: synovial fluid (rhomboid positively birefringent crystals), X-ray (chondrocalcinosis), ultrasound, ESR/CRP, calcium, phosphate, magnesium, iron, PTH.
Management
Rest, ice packs, physiotherapy after the flare, education.
NSAIDs: A: ibuprofen 400–800 mg every 8 hours for 3 days, OR C: diclofenac 50 mg every 12 hours, OR A: piroxicam 20 mg daily for 3–5 days, OR D: meloxicam 7.5–15 mg daily for 3–5 days, OR S: ketoprofen 75 mg every 8 hours; ketoprofen gel 2.5% every 6 hours.
D: Colchicine 1 mg stat then 0.5 mg 2–3 times a day.
A: Prednisolone 20–40 mg once daily tapered over 7–10 days, OR S: triamcinolone acetonide 10–40 mg intra-articular for one joint.
Prevention: colchicine 0.5 mg every 12–24 hours for frequent attacks; correct magnesium deficiency and treat hypothyroidism.
Urate-lowering therapies used in gout are not effective in CPPD.