CPPD Deposition Disease.

Figure 1 - A healthy joint

Figure 2 - Enlarged view of deposit sites of CPPD crystals in knee joint

Causes and effects

Causes

The symptoms of CPPD crystal deposition disease are caused by two processes:

1. the presence of tiny CPPD crystals in the joints and
2. the body's reaction to these crystals.

In a healthy joint, a firm, rubbery material called cartilage covers the end of each bone. Cartilage acts as a cushion, or shock absorber, between the bones. Joint tissue is enclosed by a capsule. The capsule is lined by a thin material called the synovial membrane. The membrane releases a slippery or sticky fluid, called the synovial fluids into the enclosed joint space. This liquid helps the joint tissues move smoothly and easily (see figure 1).

The CPPD crystals, although first found in the joint cartilage, also can occur later in the synovial membrane and synovial fluid (see figure 2). This probably is a result of their release from the cartilage. When crystals are present only in the cartilage, they may cause no symptoms. The body is more likely to react to crystals released into the joint fluid.

Scientists don't know why the body forms CPPD crystals. In some instances these crystals occur because of an abnormality in the cartilage cells. In other instances another disease such as osteoarthritis occurs first and causes cartilage cells or connective tissue to become abnormal.

Other conditions sometimes occur in people with CPPD crystal deposition disease and may cause or aggravate the symptoms. If you have CPPD crystal deposition disease, you should also be checked for:

• Hemochromatosis: An inherited condition in which there is too much iron in the body. This can lead to diabetes or liver and heart problems. These problems are preventable if hemochromatosis is recognized in time.
• Hyperparathyroidism: A condition caused by an overactive or hyperactive parathyroid gland in which there is too much calcium in the blood; this can lead to CPPD crystal deposition disease as well as bone and kidney problems.
• Hypothyroidism: A condition caused by an underactive thyroid gland in which there are low levels of thyroid hormone; this may lead to extreme tiredness, weight gain, skin dryness, and sensitivity to cold.
• Hypomagnesemia: A condition of low levels of magnesium in the blood. Since magnesium is needed by the body to use pyrophosphate, low levels can result in CPPD crystal deposition disease.

Your doctor may check for these and other lesser-known disorders. The possibility of them occurring needs to be considered, as many are easily treated. CPPD crystal deposition disease may sometimes be an important clue in detecting other treatable and preventable conditions.

There is one other possible cause of CPPD crystal deposition disease--heredity/genetic makeup. In some cases, CPPD crystal deposition disease may run in families and may be more common in some ethnic groups. Although CPPD crystal deposition disease is caused by calcium-containing crystals, it is not caused by drinking milk or by calcium in your diet. It is not contagious, so you can't give it to others or catch it from someone else. In some cases, surgery, a medical illness, or a joint injury may trigger episodes of pain and swelling in the disease.

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