Calcium Pyrophosphate Dihydrate, Hydroxyapatite, and Miscellaneous Crystals

  • Geraldine McCarthy


Calcium pyrophosphate dihydrate (CPPD) and hydro-xyapatite crystals are the most common calcium-containing crystals associated with joint and periarticular disorders. Deposition of these crystals is frequently asymptomatic or can be intermittently symptomatic. However, common clinical manifestations of calcium crystal deposition include acute or chronic inflammatory and degenerative arthritides, and certain forms of periarthritis. In addition to these, a number of other crystalline materials have been identified less commonly in synovial or bursal fluid. These include calcium oxalate, cholesterol, lipids, and synthetic corticosteroid crystals.


Synovial Fluid Rotator Cuff Basic Calcium Phosphate Tumoral Calcinosis CPPD Crystal 
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  1. 1.
    Felson DT, Anderson JJ, Naimark A, Kannel W, Meenan RF. The prevalence of chondrocalcinosis in the elderly and its association with knee osteoarthritis: the Framingham Study. J Rheumatol 1989;16:1241–1245.PubMedGoogle Scholar
  2. 2.
    Zaka R, Williams CJ. Genetics of chondrocalcinosis. Osteoarthritis Cartilage 2005;13:745–750.CrossRefPubMedGoogle Scholar
  3. 3.
    Derfus BA, Kurian JB, Butler JJ, et al. The high prevalence of pathologic crystals in pre-operative knees. J Rheumatol 2002;29:570–574.PubMedGoogle Scholar
  4. 4.
    Kirsch T. Determinants of pathological mineralization. Curr Opin Rheumatol 2006;18:174–180.CrossRefPubMedGoogle Scholar
  5. 5.
    McCarty DJ. Calcium pyrophosphate dihydrate crystal deposition disease—1975. Arthritis Rheum 1976;19:275–286.CrossRefPubMedGoogle Scholar
  6. 6.
    Masuda I, Ishikawa K. Clinical features of pseudogout attack. a survey of 50 cases. Clin Orthop 1988;173–181.Google Scholar
  7. 7.
    Ryan LM, McCarty DJ. Calcium pyrophosphate crystal deposition disease; pseudogout; articular chondrocalcinosis. In: McCarty D, ed. Arthritis and allied conditions. Philadelphia: Lea and Febiger; 1985:1515–1546.Google Scholar
  8. 8.
    Rosenthal AK, Mandel N. Identification of crystals in synovial fluids and joint tissues. Curr Rheumatol Rep 2001;3:11–16.CrossRefPubMedGoogle Scholar
  9. 9.
    O’Shea FD, McCarthy GM. Basic calcium phosphate crystal deposition in the joint—a potential therapeutic target in osteoarthritis. Curr Opin Rheumatol 2004;16:273–278.CrossRefPubMedGoogle Scholar
  10. 10.
    McCarty DJ, Halverson PB, Carrera GF, Brewer BJ, Kozin FK. Milwaukee shoulder: association of microspheroids containing hydroxyapatite crystals, active collagenase, and neutral protease with rotator cuff defects, I: clinical aspects. Arthritis Rheum 1981;24:464–473.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  • Geraldine McCarthy
    • 1
  1. 1.Division of Rheumatology, Department of MedicineUniversity College Dublin, Dublin/Mater Misericordiae University HospitalDublinIreland

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