Calcium Pyrophosphate Dihydrate Deposition Disease

(CPPD; Pseudogout; Chondrocalcinosis)


Calcium pyrophosphate dihydrate deposition disease (CPPD) is a build up of calcium crystals in the joints. These crystals cause inflammation in the joints. This can cause problems that are like arthritis, such as:

  • Pseudoosteoarthritis
  • Pseudogout

Arthritis of the Knee

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It is not known what causes CPPD. Genes may play a role since it can run in families.

Risk Factors

CPPD is more common in people over 50 years of age.

Other factors are:


In most cases, CPPD does not lead to symptoms.

If symptoms occur, they may come and go. They may happen in the knee, wrist, hand, pelvis, or hip. They may get worse over 6-24 hours.

Here are some symptoms you may have:

  • Joint pain
  • Joint stiffness, tenderness, and swelling
  • Redness over the joint


You will be asked about your symptoms and health history. A physical exam will be done.

Your body fluids may be tested. This can be done with:

  • Synovial fluid analysis —taken from the joint with a needle
  • Blood tests

Images may be needed of your bodily structures. This can be done with:


There is no cure for CPPD. The crystal deposits can’t be dissolved.

Treatment is focused on managing pain during flare-ups. Without treatment, the pain will go away on its own within days to weeks.

Talk with your doctor about the best treatment plan for you. Rest and ice may reduce pain. Here are some other methods:


Medicine may help to lower inflammation, pain, and stiffness. These are some medicines:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs)
  • Corticosteroids
  • Gout medications that change the way the body reacts to the crystals, such as colchicine


These procedures may be needed if home care and medicines do not help:

  • Arthrocentesis—to remove excess fluid and crystals
  • Corticosteroid shots—injected directly into a joint to decrease inflammation

Steroids Injected into Joint

Steroid in Knee
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CPPD can't be prevented. The cause isn't clear.


American College of Rheumatology
National Institute of Arthritis and Musculoskeletal and Skin Diseases


The Arthritis Society


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Calcium pyrophosphate dihydrate crystal deposition disease (CPPD) (Pseudogout). The Arthritis Foundation website. Available at:
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Accessed June 5, 2018.
Calcium pyrophosphate deposition (CPPD) (formerly called pseudogout). American College of Rheumatology website. Available at: Updated March 2017. Accessed June 5, 2018.
Pseudogout. Cleveland Clinic website. Available at:
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Updated December 27, 2017. Accessed June 5, 2018.
4/24/2014 DynaMed's Systematic Literature Surveillance http://www.dynamed...: Wise JN, Weissman BN, et al. American College of Radiology (ACR) Appropriateness Criteria for chronic foot pain. Available at:
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Updated 2013. Accessed June 29, 2015.
Last reviewed May 2018 by EBSCO Medical Review Board Warren A. Bodine, DO, CAQSM
Last Updated: 4/24/2014

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