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CPPD secondary causes — SCE Rheumatology MCQ

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HardCrystal arthropathiesCPPD secondary causesSCE Rheumatology

A 55-year-old man has recurrent CPP crystal arthritis and chondrocalcinosis. Corrected calcium is 2.78 mmol/L and alkaline phosphatase is mildly raised. Which investigation should be prioritized?

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

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Correct answer: A — Parathyroid hormone concentration

The best answer is “Parathyroid hormone concentration”. Relatively young-onset recurrent CPP crystal arthritis should prompt assessment for associated metabolic disease, and hypercalcaemia makes primary hyperparathyroidism the immediate concern. The other tests address lupus, Behçet disease, vasculitis or intestinal inflammation and do not explain the biochemical and crystal pattern.

Reference: NICE NG132 hyperparathyroidism recommendations: https://www.nice.org.uk/guidance/ng132/chapter/Recommendations