CURRENT CONCEPTS WITH RESPECT TO CHONDROCALCINOSIS AND THE PSEUDOGOUT SYNDROME

¹ Assistant Professor, Department of Radiology, Yale University School of Medicine.
² Assistant Professor, Department of Radiology and Department of Internal Medicine, Yale University School of Medicine.

Generalized chondrocalcinosis is most commonly seen in patients with CPPD deposition disease, also known as the pseudogout syndrome. Generalized chondrocalcinosis and pseudogout in turn are commonly noted in association with hemochromatosis, which may itself be asymptomatic and clinically unsuspected.¹⁵ Although generalized chondrocalcinosis and pseudogout have been reported in association with hyperparathyroidism, uric acid gout, and rheumatoid arthritis, a more localized form of chondrocalcinosis involving just the menisci of the knee and occasionally the triangular fibrocartilage of the wrist is usually noted in association with these diseases. Localized chondrocalcinosis has been reported in a number of entities including systemic lupus erythematosus, ochronosis, acromegaly, Wilson’s disease, hemophilia, following trauma and infection, and in asymptomatic elderly persons. In addition, diabetes mellitus appears to be more common in patients with pseudogout.

Recognition of the association of chondrocalcinosis and pseudogout with these diseases is important. Clinically unsuspected disease may be identified following the diagnosis of pseudogout. Conversely, the etiology of an acute arthritis may be erroneously thought to be due to the associated disease or secondary to degenerative joint disease alone if pseudogout and the presence of the CPPD crystal-induced synovitis is not considered.

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