Severe calcium pyrophosphate dihydrate deposition disease of the metacarpophalangeal joints

We report a case of calcium pyrophosphate deposition disease (CPPD) with an unusual presentation of severe chondrocalcinosis with atypical large burden deposited in the metacarpophalangeal joints as well as more typical deposition in wrists and knees as demonstrated on plain radiographs. A 77-year-o...

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Bibliographic Details
Published in:BMJ case reports 2018-09, Vol.2018, p.bcr-2018-226132
Main Authors: Rigsbee, Cody A, Sizemore, Travis C, Lohr, Kristine M
Format: Article
Language:English
Subjects:
Aged
Ankle
Ankle Joint - diagnostic imaging
Anti-Inflammatory Agents - therapeutic use
Arthralgia - etiology
Arthritis
Calcium Pyrophosphate - metabolism
Case reports
Chondrocalcinosis - complications
Chondrocalcinosis - diagnosis
Chondrocalcinosis - drug therapy
Chondrocalcinosis - metabolism
Diagnosis, Differential
Female
Fingers & toes
Hands
Humans
Kidney diseases
Knee Joint - diagnostic imaging
Metacarpophalangeal Joint - diagnostic imaging
Pain
Prednisone - therapeutic use
Unusual Presentation of More Common Disease/Injury
Wrist
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Description
Summary:We report a case of calcium pyrophosphate deposition disease (CPPD) with an unusual presentation of severe chondrocalcinosis with atypical large burden deposited in the metacarpophalangeal joints as well as more typical deposition in wrists and knees as demonstrated on plain radiographs. A 77-year-old African-American woman 1-year status post parathyroidectomy for hyperparathyroidism initially presented to the rheumatology clinic to treat suspected rheumatoid arthritis given her pattern of joint involvement but was found to have CPPD. The patient’s history is notable for end-stage renal disease which complicates medical management. This case illustrates radiographic findings of CPPD and explores the challenges of treating CPPD in the setting of comorbid conditions.
ISSN:1757-790X
1757-790X
DOI:10.1136/bcr-2018-226132