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Pathology: Arthropathy caused by Calcium Pyrophosphate (CPP) Crystals

Pathology is the identification of the presence of an abnormal condition, particularly one caused by calcium pyrophosphate (CPP) crystals, which can manifest as a type of arthropathy.


Aetiology is the search for the cause of the pathology. In this case, it could be primary or secondary hyperparathyroidism, haemochromatosis, hypothyroidism, hypophosphataemia, or Wilson's Disease.


The patient may suffer from a monoarthritis, with a painful, swollen, hot, erythematous joint for a period of anywhere between 7-14 days. The most common sites affected include the shoulders, knees and wrists.


In addition to the primary symptoms, the patient may also exhibit joint effusions.


  • Joint aspirate: Positively Birefringent Rhomboid-shaped crystals
  • Imaging: X-Rays showing chondrocalcinosis


Treatment of arthropathy caused by CPP crystals is generally conservative and includes rest, as well as non-steroidal anti-inflammatory drugs (NSAIDs) and intra-articular steroids.


The primary complication associated with this type of pathology is degenerative arthritis.


The prognosis for arthropathy caused by CPP crystals is generally good, although there can be reconstructive changes such as osteoarthritis.

Figure 8.4 Positively Birefringent Rhomboid-shaped crystals:

Rectangle: Rounded Corners: NOTE FOR PUBLISHERS –     Image of Positively Birefringent Rhomboid-shaped crystals

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