OA and CPPD Coexistence — SCE Rheumatology MCQ

Instant feedback + full explanation. One question, done properly.

EasyCrystal ArthropathyOA and CPPD CoexistenceSCE Rheumatology

A 55-year-old woman has bilateral hand and wrist pain with brief morning stiffness. Radiographs show joint-space narrowing, osteophytes and subchondral sclerosis at the scaphotrapeziotrapezoid joints, together with linear calcification of the triangular fibrocartilage complexes. Which pair of conditions best accounts for these findings?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: D — Osteoarthritis and calcium pyrophosphate crystal deposition

The correct answer is **C: osteoarthritis and calcium pyrophosphate crystal deposition (CPPD)**. Joint-space narrowing, osteophytes and subchondral sclerosis are characteristic of osteoarthritis. Linear calcification within the wrist triangular fibrocartilage complex is chondrocalcinosis, a typical radiographic manifestation of CPP crystal deposition. Osteoarthritis with CPPD is a recognised clinical phenotype, and scaphotrapeziotrapezoid osteoarthritis is associated with CPPD. Haemochromatosis predisposes to CPPD but is not demonstrated by these radiographs and does not imply rheumatoid arthritis. Rheumatoid arthritis would more typically produce inflammatory symptoms, synovitis and marginal erosions rather than osteophyte-predominant change. Gout, psoriatic arthritis and SLE are likewise unsupported by the described distribution and imaging findings.

Reference: Filippou G et al. Gout, Hyperuricemia and Crystal-Associated Disease Network (G-CAN) consensus statement regarding labels and definitions for disease elements in calcium pyrophosphate crystal deposition (CPPD). Annals of the Rheumatic Diseases, 2026. https://pubmed.ncbi.nlm.nih.gov/21216817/