Chondrocalcinosis of the knee
In most cases, chondrocalcinosis first appears on the knee. In the primary form, the knee is also affected in 99% of cases, and in the secondary forms, the knee is also affected in at least 90% of cases. In half of the cases the knee is the first affected structure.
It shows the typical symptoms. Pain at rest, which worsens with movement, leads to limited mobility in the knee. This is usually accompanied by swelling and redness, which also manifests itself in overheating of the skin.
These are signs of the inflammatory processes taking place in the knee. The picture of chondrocalcinosis of the knee is then similar to an attack of gout, which however usually begins at the big toe, or arthrosis. In the course of the disease, other joints can be affected.
Three main methods are used in the diagnosis of chondrocalcinosis. On the one hand, the deposits can be visible on X-rays, and on the other hand it is useful to examine blood samples in the laboratory and include them in the diagnosis. In addition to X-rays and the laboratory, a joint puncture is sometimes necessary as part of the diagnosis in order to take joint fluid and look at it under the microscope.
However, this is used especially in cases of doubt, when the diagnosis after X-ray and laboratory was not sufficient. It is also important not to be too sure of having to treat gout at the onset of symptoms. This requires a different therapy.
In contrast to chondrocalcinosis, gout does not start at the knee, but mostly at the big toe. Furthermore, gout has other causes. In gout, uric acid crystals and not calcium pyrophosphate are responsible for the symptoms.
X-rays are one of the most important examinations in the diagnosis of chondrocalcinosis. Even if the suspicion of this disease is not obvious, if the symptoms persist, an X-ray is usually requested to diagnose the painful joints. Here, the deposits of crystals in the cartilage become visible, as they are radiopaque structures that stand out clearly next to the cartilage.
In an X-ray, fine, strip-like structures can then be seen in the joint space of the knee, hip or shoulder, which usually run parallel to the bone. Depending on the stage of the disease, the X-ray image shows more or less pronounced lines. The deposits can almost always be seen in painful processes.
Often, the diagnosis of chondrocalcinosis on X-rays is also a chance finding in the diagnosis of other diseases. In a healthy person, the cartilage is not visible on X-rays. Especially on the knee, hip and other large joints, but also on the hands, X-rays are the first step in the diagnosis.
As an alternative, in addition to X-rays of the affected areas, an ultrasound examination is also available, in which calcification can also be detected. In addition to the X-ray, a blood test in the laboratory also provides further information about the disease and its course. Although the laboratory is negligible in the primary diagnosis, it plays a not unimportant role in estimating the extent of the disease and for follow-up examinations.
In the laboratory, chondrocalcinosis shows increased signs of inflammation (leukocytes, CRP value), which are a correlative for the inflammation in the joint. These should decrease with successful therapy. Other values that are important for the diagnosis of secondary chondrocalcinosis can also be determined in the laboratory.
Thus, the laboratory should definitely cover the (secondary) thyroid gland values, iron, magnesium and phosphate, as deviations of these parameters can be an indication of secondary chondrocalcinosis caused by a basic disease. In this case, the therapy of these diseases has priority. Chondrocalcinosis requires therapy only in rare cases.
The disease is then already relatively far advanced. The therapy is similar to that of rheumatism or arthrosis. Anti-inflammatory agents such as ASA or naproxen are used, which also have a pain-relieving effect.
Especially in the acute phase they can alleviate the symptoms. Cold applications also relieve the symptoms. Colchicine is given as an alternative in a batch.
Pain and inflammation are usually well controlled with these measures. In chronic cases, heat rather than cold applications help to maintain mobility and be pain-free. In a few cases, chondrocalcinosis requires invasive therapy.
If the focus is on joint effusion, a joint puncture must be considered to relieve the strain. Here, the doctor penetrates the joint under sterile conditions with a needle and drains fluid. However, the indication for joint puncture should be strictly defined, as there is always the risk of bacteria being carried into the joint, which can lead to infection.
As a last resort in therapy, surgery is performed if, for example, the menisci in the knee have already been destroyed too far. These are then removed. In addition, naturally predisposing diseases such as metabolic diseases should be treated adequately in order to provide causal therapy for chondrocalcinosis.
There are also various homeopathic remedies that are frequently used against rheumatic diseases, including chondrocalcinosis. A well-known remedy in homeopathy in this area is Solanum malacoxylon. It is used against the pain in the joint as well as the inflammation.
If the symptoms are initially mild, it is possible to consider homeopathic therapy, but an additional orthodox medical clarification should be carried out. In addition, homeopathy can be given to accompany chondrocalcinosis in order to support the healing process. However, an actual effect has not yet been proven.
