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Calcium pyrophosphate deposition disease — SCE Rheumatology MCQ

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ModerateCrystal arthropathiesCalcium pyrophosphate deposition diseaseSCE Rheumatology

A 71-year-old woman has recurrent wrist and knee attacks labelled as gout. During a flare, serum urate is 310 µmol/L, knee aspiration shows positively birefringent rhomboid crystals and X-ray shows triangular fibrocartilage calcification. What is the most likely diagnosis?

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Correct answer: E — Calcium pyrophosphate deposition disease

Rhomboid positively birefringent crystals and chondrocalcinosis support CPPD rather than gout. Serum urate can be normal during gout flares, but the crystal morphology is decisive. Wrist involvement and triangular fibrocartilage calcification are classic CPPD clues.

Reference: EULAR CPPD recommendations; BSR rheumatology curriculum