Calcium Pyrophosphate Dehydrate Crystal Deposition

Arthropathies associated with crystals deposition are acute gouty arthritis, chronic gout and chronic tophaceous gout due to monosodium urate crystals. Then there is acute pseudogout and chronic pyrophosphate arthropathy caused by calcium pyrophosphate dehydrate crystals. Acute calcific periarthritis, acute hydroxylapatite arthritis and chronic hydroxyapatite arthritis including Milwaukee-shoulder-knee syndrome are due to basic calcium-phosphate-hydroxyapatite crystals. 

The deposition of crystals of monosodium urate (gout), calcium pyrophosphate dehydrate (CPPD chondrocalcinosis, pseudogout) and calcium hydroxyapatite (HADD calcifying tendinitis) within synovium, articular cartilage, fibrocartilages and para-articular soft tissues may produce a spectrum of clinical conditions ranging from asymptomatic entities to severe rapidly destructive arthropathy (Steinbach 2004 Clement et al. 2005). The accumulation of crystals takes months to years to develop and leads to the establishment of a chronic synovitis with intermittent acute flares. 

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