Calcium crystal diseases (pseudogout)

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What are calcium crystal diseases?

Deposits of two types of calcium crystals can cause sudden attacks of painful inflammation in and around your joints:

  • Calcium pyrophosphate (CPP) crystals deposit within the joints and can cause acute CPP crystal arthritis (also known as pseudogout).
  • Apatite crystals can occur inside joints, but they also deposit in tendons and cause acute calcific tendinitis.

Both CPP and apatite crystals more commonly form in joints that have arthritis.

What are the symptoms of calcium crystal diseases?

If you have CPP crystal arthritis, your symptoms may include:

  • sudden pain and stiffness in the affected joint (most commonly the knee)
  • swelling and tenderness
  • red, inflamed skin over the joint
  • raised temperature

These tend to last several days to 2 weeks before completely settling.

If you have acute calcific tendinitis, your symptoms may include:

  • painful swelling around the joint (most commonly shoulder)
  • redness and tenderness around the joint

These usually settle back to normal after 2–4 weeks.

Who gets calcium crystal diseases?

Acute CCP crystal arthritis usually affects those in late middle-age or older. Acute calcific tendinitis generally affects young or middle-aged adults.

What causes calcium crystal diseases?

Calcium crystal diseases can be caused by:
  • chemical imbalances, which can trigger an increase in crystal production
  • changes in cartilage due to osteoarthritis encouraging calcium crystal formation
  • crystals being shaken loose into joints or tendons by injuries to the area, having a fever (for example a chest infection) or having a stress to your body (such as an operation)
  • your immune system’s response to the crystals

How are calcium crystal diseases diagnosed?

To determine a diagnosis of calcium crystal disease, your doctor will probably need to carry out tests to rule out other conditions.

What treatments are there for calcium crystal diseases?

Although the attacks of inflammation clear up by themselves, some treatments can help with the pain, inflammation and length of the attack. These include:
  • drugs like simple painkillers or non-steroidal anti-inflammatory drugs (NSAIDs) to relieve pain
  • using ice packs to reduce inflammation
  • doing regular exercise to help with recovery
  • draining fluid from affected joints (aspiration) and then injecting a small amount of long-acting steroid to help pain and prevent fluid building up again
  • surgery such as washing out your knee joint (this process is called lavage)

Self-help and daily living for calcium crystal diseases

Try the following tips to help ease the symptoms of calcium crystal diseases:
  • Exercise little and often.
  • Eat a well-balanced diet.
  • Apply an ice pack to the affected joint.

Is osteoarthritis with calcium crystals different from osteoarthritis without calcium crystals?

Many people with osteoarthritis have calcium pyrophosphate crystals in their affected joint cartilage, often in the knee. This combination is called osteoarthritis with calcium pyrophosphate crystal deposition (osteoarthritis with CPPD for short).

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