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Calcium pyrophosphate deposition disease

Guidelines

Key sources

The following summarized guidelines for the evaluation and management of calcium pyrophosphate deposition disease are prepared by our editorial team based on guidelines from the European League Against Rheumatism (EULAR 2024,2022,2011), the American College of Rheumatology (ACR 2023), and the American College of Radiology (ACR 2017). ...
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Diagnostic investigations

Diagnostic imaging: as per EULAR 2024 guidelines, obtain conventional radiography and ultrasound (or CT if axial involvement is suspected) for the evaluation of CPPD.
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  • Screening for chronic infections

Medical management

General principles: as per EULAR 2011 guidelines, offer both nonpharmacological and pharmacological modalities for optimal treatment of patients with CPPD, tailored according to:
clinical features (isolated chondrocalcinosis, acute, chronic calcium pyrophosphate crystal inflammatory arthritis, OA with CPPD)
general risk factors (age, comorbidities)
the presence of a predisposing metabolic disorder.
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  • Management of acute CPP crystal arthritis

  • Management of chronic CPP crystal arthritis

  • Management of OA with CCPD

Preventative measures

Routine immunizations: as per ACR 2023 guidelines, consider offering high-dose or adjuvanted influenza vaccination, rather than regular-dose influenza vaccination, in ≥ 65 years old patients with rheumatic or musculoskeletal diseases and in 18-65 years old patients with rheumatic or musculoskeletal diseases on immunosuppressive medications.
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