Calcium Pyrophosphate Dihydrate Deposition Disease

(CPPD; Pseudogout; Chondrocalcinosis)


Calcium pyrophosphate dihydrate deposition disease (CPPD) is a buildup of calcium crystals in the joints. This results in inflammation in the joints.

Arthritis of the Knee

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In most people, the cause is not known. In others, genes may play a role.

Risk Factors

This problem is more common in people who are over 50 years of age.

Other things that may raise the risk are:

  • Prior joint damage
  • Osteoarthritis
  • Having other family members with this disease
  • Poor knee alignment early in life.
  • Hormonal and metabolism problems, such as:


Most people do not have symptoms. Those who do may have pain in the knee, wrist, hand, pelvis, or hip. It may get worse over a 6 to 24 hour span. Symptoms may also flare up and then go away for a time before returning.

Problems may be:

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


The doctor will ask about your symptoms and health history. A physical exam will be done.

Your blood may be tested.

A needle may be used to remove and test a sample of the fluid in a joint. This can be done with a synovial fluid analysis.

Images may be needed. This can be done with:


There is no cure. The goal of treatment is to manage symptoms during flare-ups. Choices are:

  • Supportive care, such as cold compresses and resting the joint
  • Medicines to ease pain and swelling, such as:
    • Nonsteroidal anti-inflammatory drugs (NSAIDs)
    • Corticosteroids
    • Gout medicines like colchicine that change the way the body reacts to the crystals

People who are not helped by these methods may need arthrocentesis. It uses a needle to remove excess fluid from a joint.


There are no known guidelines to prevent this health problem.


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


The Arthritis Society


Calcium pyrophosphate deposition (CPPD). American College of Rheumatology website. Available at: Accessed February 16, 2021.
Calcium pyrophosphate dihydrate deposition disease. EBSCO DynaMed website. Available at: Accessed February 16, 2021.
Calcium pyrophosphate dihydrate crystal deposition disease (CPPD) (Pseudogout). The Arthritis Foundation website. Available at:
...(Click grey area to select URL)
Accessed February 16, 2021.
Calcium pyrophosphate dihydrate deposition disease (CPPD, or Pseudogout). Cleveland Clinic website. Available at:
...(Click grey area to select URL)
Accessed February 16, 2021.
Rosenthal AK, Ryan LM. Calcium Pyrophosphate Deposition Disease. N Engl J Med. 2016 Jun 30;374(26):2575-2584.
Last reviewed December 2020 by EBSCO Medical Review Board Warren A. Bodine, DO, CAQSM
Last Updated: 2/16/2021

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