Chondrocalcinosis: An Early Sign of Primary Hyperparathyroidism

For citation: Eliseev M.S., Novikova A.M., Zhelyabina O.V. Chondrocalcinosis: An Early Sign of Primary Hyperparathyroidism. Doctor.Ru. 2020; 19(11): 52–55. (in Russian). DOI: 10.31550/1727-2378-2020-19-11-52-55
30 December 09:42

Objective: To deeply analyse a case of a patient with calcium pyrophosphate crystal storage disease, where chondrocalcinosis (CC) preceded primary hyperparathyroidism (PHPT).

Key Points. The association of CC and hyperparathyroidism is well-known; and CC is recognised as one of the late signs of hyperparathyroidism. We describe a 67-year old patient with PHPT, presenting for a long time only with X-ray CC and chronic arthritis, associated with calcium pyrophosphate deposits. At the same time, he did not have any electrolyte imbalances, had normal serum calcium and parathyroid hormone levels; PHPT was diagnosed after 10 years of follow-up when the patient developed life-threatening hypercalcemia.

It can be assumed that, unlike other musculoskeletal signs, CC can be one of the earliest symptoms of hyperparathyroidism. Treating CC as a late sign of hyperparathyroidism is likely to be associated with challenges of early diagnosis (asymptomatic in some patients, low sensitivity of X-ray diagnostics). In order to assess the diagnostic value of CC in hyperparathyroidism, including patients with normal calcium levels, specific tests are essential.

Conclusion. Target examination for CC using highly-sensitive methods in patients with minor calcium metabolism disturbances, high/normal parathyroid hormone level or slightly increased parathyroid hormone level and normal calcium can improve the detection frequency of both CC and PHPT and follow-up of such patients. Early PHPT diagnosis (prior to clinical presentation) can help in preventing severe, life-threatening complications.

Contributions: Eliseev, M.S. — data collection and analysis; selection of thematic publications; article preparation and academic reviewing; Novikova, A.M. — data collection and analysis; selection of thematic publications; article preparation; Zhelyabina, O.V. — follow-up, dynamic patient monitoring, processing of information, text of the article.

Conflict of interest: The authors declare that they do not have any conflict of interests.

Source of funding: The article is prepared as a part of a fundamental scientific topic “Elaboration of Complex Therapies for Musculoskeletal System Disorders” No. АААА-А19-119021190150-6.

M.S. Eliseev (Corresponding author) — Nasonova Scientific and Research Institute of Rheumatology; 34А Kashirskoye Shosse, Moscow, Russian Federation 115522. eLIBRARY.RU SPIN: 2524-7320. E-mail:

A.M. Novikova — Nasonova Scientific and Research Institute of Rheumatology; 34А Kashirskoye Shosse, Moscow, Russian Federation 115522. eLIBRARY.RU SPIN: 3821-1050. E-mail:

O.V. Zhelyabina — Nasonova Scientific and Research Institute of Rheumatology; 34А Kashirskoye Shosse, Moscow, Russian Federation 115522. eLIBRARY.RU SPIN: 8038-6195. E-mail:


Fig. Radiocarpal, metatarsophalangeal chondrocalcinosis. Image courtesy of the authors


Received: 28.10.2020
Accepted: 07.12.2020

30 December 09:42
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