Category: Orthopedics
Posted: 11/8/2025 by Brian Corwell, MD
(Updated: 12/5/2025)
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Chondrocalcinosis is a condition where calcium pyrophosphate crystals form in the joints (particularly the knee and wrist), leading to inflammation and pain.
Appears as a cloudlike radiopacity in the knee’s articular cartilage and meniscus on XR, reflecting abnormal calcium-based crystal deposition.
This can be distinguished from the radiolucent appearance of monosodium urate crystals of gout.
https://www.wikidoc.org/index.php/File:MSUandCPPD.png
These calcium crystals are common in end-stage knee osteoarthritis and have been associated with disease severity.
Due to this well-observed coexistence (chondrocalcinosis and knee osteoarthritis), chondrocalcinosis is commonly considered a manifestation of osteoarthritis pathology.
However, this does not explain the commonly encountered instances where chondrocalcinosis appears in radiographically normal knees. This raises questions of whether chondrocalcinosis is a cause or merely a consequence of end-stage osteoarthritis.
Population studies have identified that about 6.% of individuals have chondrocalcinosis in joints unaffected by osteoarthritis
In a recent analysis including more than 6400 middle-aged to older adults, individuals with knee chondrocalcinosis were 75% more likely to develop knee OA than those without the condition at baseline.
Chondrocalcinosis may contribute to the risk of osteoarthritis through inflammation. These deposited crystals could induce the production of inflammation markers, matrix-degrading enzymes and induce chondrocyte hypertrophy or chondrocyte death. These effects not only damage the joint but also form a positive feedback loop to produce more calcium crystals.
Individuals with chondrocalcinosis may represent a specific subgroup of patients, for which a treatment targeting chondrocalcinosis induced inflammation may present a viable strategy to prevent osteoarthritis in this patient subgroup.
This idea has some support from the 2023, LoDoCo2 trial, (approx. 5500 patients) which showed an association between the use of colchicine, 0.5 mg daily, with a lower incidence of total knee and total hip replacements.
Wu Y, Liew JW, et al. Chondrocalcinosis and incident knee osteoarthritis: findings from 2 large prospective cohorts with 20 years of follow-up. Ann Rheum Dis. 2025 Oct;84(10):1743-1751.
