Common and differentiating features of arthritis related to HH, CPPD disease, and OA

	Arthritis related to HH	CPPD disease	OA
Substance deposited in the synovium	Iron	CPP crystals	May have basic calcium phosphate crystals
Commonly involved joints	2^nd and 3^rd MCP joints Wrists Shoulders Knees Hips	2^nd and 3^rd MCP joints Wrists Knees Hips	1^st CMC joint 1^st MTP joint Finger DIP and PIP joints Knees Hips
Degree of synovial inflammation	Mild to moderate	Variable, may be severe in the context of acute CPP crystal arthritis	Mild
Key laboratory findings	ESR and CRP may be elevated Elevated ferritin and transferrin saturation	Synovial fluid with positively birefringent CPP crystals ESR and CRP may be elevated, especially during an episode of acute CPP crystal arthritis	Noninflammatory synovial fluid without birefringent crystals Normal ESR and CRP
Common comorbid conditions	Osteoporosis OA CPPD disease Other conditions depend on organ involvement	Periarticular osteoporosis OA

To be used with UpToDate content on arthritis related to HH, CPPD disease, and OA.

CMC: carpometacarpal; CPP: calcium pyrophosphate; CPPD: calcium pyrophosphate deposition; CRP: C-reactive protein; DIP: distal interphalangeal joint; ESR: erythrocyte sedimentation rate; HH: hereditary hemochromatosis; MCP: metacarpophalangeal; MTP: metatarsophalangeal; OA: osteoarthritis; PIP: proximal interphalangeal joint; RA: rheumatoid arthritis.

Reference:

Mitton-Fitzgerald E, Gohr CM, Williams CM, Rosenthal AK. Identification of common pathogenic pathways involved in hemochromatosis arthritis and calcium pyrophosphate deposition disease: A review. Curr Rheumatol Rep 2022; 24:40.

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Common and differentiating features of arthritis related to HH, CPPD disease, and OA