Nonpharmacologic and pharmacologic management of CPP crystal arthritis and BCP arthropathy and periarticular syndromes

Rheum Dis Clin North Am. 2014 May;40(2):343-56. doi: 10.1016/j.rdc.2014.01.010. Epub 2014 Feb 19.

Abstract

Calcium crystal arthritis is often unrecognized, poorly managed, and few effective therapies are available. The most common types of calcium crystals causing musculoskeletal syndromes are calcium pyrophosphate (CPP) and basic calcium phosphate (BCP). Associated syndromes have different clinical presentations and divergent management strategies. Acute CPP arthritis is treated similarly to acute gouty arthritis, whereas chronic CPP and BCP arthropathy may respond to strategies used for osteoarthritis. Calcific tendonitis is treated with a variety of interventions designed to dissolve BCP crystals. A better understanding of the causes and larger well-planned trials of current therapies will lead to improved care.

Keywords: Acute calcific tendinitis; Basic calcium phosphate; Calcium pyrophosphate; Chondrocalcinosis; Hydroxyapatite; Pseudogout; Therapy.

Publication types

  • Review

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use*
  • Anti-Inflammatory Agents / therapeutic use
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use*
  • Antirheumatic Agents / therapeutic use*
  • Calcinosis / therapy
  • Calcium Phosphates
  • Chondrocalcinosis / therapy*
  • Colchicine / therapeutic use*
  • Durapatite
  • Gout Suppressants / therapeutic use*
  • High-Energy Shock Waves / therapeutic use*
  • Humans
  • Interleukin 1 Receptor Antagonist Protein / therapeutic use
  • Periarthritis / therapy*
  • Tendinopathy / therapy*

Substances

  • Adrenal Cortex Hormones
  • Anti-Inflammatory Agents
  • Anti-Inflammatory Agents, Non-Steroidal
  • Antirheumatic Agents
  • Calcium Phosphates
  • Gout Suppressants
  • Interleukin 1 Receptor Antagonist Protein
  • Durapatite
  • calcium phosphate
  • Colchicine

Supplementary concepts

  • Chondrocalcinosis 2