Frequency and determinants of calcium pyrophosphate dihydrate deposition in patients with rheumatoid arthritis: A radiologic study

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Pekdiker M., Kimyon G.

Ulusal Romatoloji Dergisi, cilt.17, sa.3, ss.188-194, 2025 (Scopus, TRDizin)

Özet

Objective: Previous joint injury predisposes to calcium pyrophosphate dihydrate deposition (CPPD). In this study, we aimed to identify the frequency and associated factors of radiographic CPPD signs in cases of rheumatoid arthritis (RA).

Methods: Adult patients with RA who were referred to our tertiary rheumatology department between January 2023 and December 2024 were included. Patients with secondary rheumatologic diseases and conditions predisposing to CPPD were excluded. Chondrocalcinosis, scapholunate advanced collapse, scaphoid-trapezium-trapezoid joint collapse, and hook-like osteophytes on hand X-rays were defined as the signs of CPPD. Radiographs were read by two blinded rheumatologists.

Results: We included a total of 1,318 patients; 83% of them were female. The mean age was 55.2 years, and the mean disease duration was 8.6 years. Rheumatoid factor and anti-cyclic citrullinated peptide (CCP) positivity were 56.2% and 52.7%, respectively. 95.5% of the patients had RA-type erosive changes. We found the frequency of CPPD as 10.5% (n=139). The most common CPPD sign was chondrocalcinosis of distal interphalangeal joints (n=70), and hooklike osteophytes were the second (n=48). The mean age (p<0.001), disease duration (p=0.002), anti-CCP negativity (p<0.001), and RAtype serious joint involvement (p=0.008) were significantly higher in the CPPD+ group. In multivariate analysis, age (p<0.001), disease duration (p=0.007), and anti-CCP negativity (p=0.002) were the independent predictive factors for CPPD.

Conclusion: Our findings align with prior literature suggesting that joint damage in RA may predispose patients to CPPD. Moreover, CPPD is a clinical entity that should be kept in mind in the management of RA.