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Case Reports
. 2025 Jan 4;17(1):e76897.
doi: 10.7759/cureus.76897. eCollection 2025 Jan.

Four Cases of Calcium Pyrophosphate Deposition Disease Presenting With Polymyalgia-Like Symptoms and Chondrocalcinosis in the Shoulder and Hip Joints Identified on CT Imaging

Ryosuke Ono  1   2 , Ken Horibata  1   2
Affiliations
Case Reports

Four Cases of Calcium Pyrophosphate Deposition Disease Presenting With Polymyalgia-Like Symptoms and Chondrocalcinosis in the Shoulder and Hip Joints Identified on CT Imaging

Ryosuke Ono et al. Cureus. .

Abstract

Calcium pyrophosphate deposition (CPPD) disease is a rheumatic disorder frequently observed in elderly individuals, often presenting with symptoms resembling polymyalgia rheumatica (PMR). Despite differing treatment strategies for these conditions, a definitive method for distinguishing between them remains unestablished. We report the cases of four elderly patients initially presenting with polymyalgia (PM), ultimately diagnosed with CPPD disease. Early-stage CT scans in all cases demonstrated chondrocalcinosis (CC) in the shoulder and hip joints. These findings suggest that PM in CPPD disease is attributable to calcium pyrophosphate deposition in these joints. Moreover, the identification of CC via CT imaging may aid in differentiating CPPD disease with PM from true PMR. Further research is warranted to refine this diagnostic distinction.

Keywords: calcium pyrophosphate deposition disease (cppd); chondrocalcinosis; crown dense syndrome; pmr; polymyalgia; polymyalgia rheumatica; pseudo-gout; rheumatoid arthritis; seronegative rheumatoid arthritis.

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Conflict of interest statement

Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Kameyama Municipal Medical Center Medical Research and Ethics Committee issued approval (2024112001). Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Right shoulder and bilateral hip joints of Case 1 showing chondrocalcinosis (△).
Figure 2
Figure 2. Axial vertebral region and bilateral hip joints of Case 2 showing chondrocalcinosis (△); fluid accumulation observed in the right hip bursa (↑).
Figure 3
Figure 3. Right shoulder and left hip joint of Case 3 showing chondrocalcinosis (△)
Figure 4
Figure 4. Axial vertebral region, right shoulder, and bilateral hip joints of Case 4 showing chondrocalcinosis (△)
See this image and copyright information in PMC

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