Key Takeaway:

Individuals with acute calcium pyrophosphate crystal arthritis had twice the risk of fractures than people without the condition.

Joint swelling, discomfort, and inflammation can occasionally result from calcium pyrophosphate deposition (CPPD) disease, which is caused when crystals of calcium pyrophosphate (CPP) accumulate close to cartilage cells.

Prior research has indicated a correlation between low bone density and chronic pelvic pain. Recent findings from models in the lab indicate that loss of function of the protein osteoprotegerin, which typically prevents bone resorption, may lead to increased development of osteoclasts, which break down old bone and may have a role in the etiology of illness.

More than 1,100 patients who experienced acute CPP crystal arthritis, the acute inflammatory manifestation of CPPD, at least once between 1991 and 2017 were included in the study. They were matched with almost 3,300 comparators who may have had various forms of arthritis but did not have acute CPP crystal arthritis.

The first fragility fracture (fractures originating from a fall from standing height or lower) at the wrist, hip, pelvis, or humerus was the main outcome of the study. The initial fracture at each of these anatomic locations was a secondary outcome.

After controlling for conventional fracture risk variables, the researchers discovered that the fracture rate was twice as high in the acute crystal CPP arthritis cohort as in the comparator group: 11.2 per 1,000 s cohort as in the comparator group: 11.2 per 1,000 person-years vs. 5.6 per 1,000 s cohort as in the comparator group: 11.2 per 1,000 person-years. Over time, the difference between the two groups grew, and similar results were obtained from the sensitivity analyses.

To conclude, patients with acute CPP crystal arthritis had twice the risk of fracture. Future research is required to assess bone turnover markers and how patients with CPPD’s bone density varies over time.

Reference: Tedeschi S et al. Fractures in Patients with Acute CPP Crystal Arthritis versus Matched Comparators in a Large Cohort Study. ACR Convergence 2023.