Adults
Calcium pyrophosphate deposition (CPPD)
Recurrent pseudogout, chronic CPP arthritis that mimics RA or OA, or onset before 60.
What to look for
- Acute monoarthritis (knee, wrist) in older adults, often after illness or surgery
- Chronic inflammatory arthritis resembling RA, or OA in unusual joints (MCP, wrist, shoulder)
- Chondrocalcinosis on X-ray or ultrasound. CPP crystals (weakly positive birefringent) in synovial fluid confirm it.
What to do
- Aspirate and examine fluid for crystals and culture when possible.
- If onset is before about 60, or disease is polyarticular, screen for metabolic causes: calcium, phosphate, magnesium, ferritin and transferrin saturation (hemochromatosis), alkaline phosphatase, TSH.
About this urgency level
Specialist evaluation helps, but these are usually less time-sensitive than new inflammatory arthritis or connective tissue disease.
Timeframes are typical targets. Local pathways, capacity and clinical judgment come first.