They usually present with severe pain and swelling reaching a maximum within 6-24 hours of onset. The most commonly affected joints are the knees. Examination reveals a very painful restricted joint, tense effusion, increased warmth and often erythema in the overlying skin. Fever is common, and elderly patients may be unwell and confused. Aspirated synovial fluid is turbid and contains positive birefringent CPPD crystals on polarised light microscopy.
Attacks are usually self-limiting, resolving in one to three weeks.
This is typically a disorder of those over 65 years of age. Symptoms are bilateral and symmetrical, affecting the shoulder and pelvic girdle regions. Occasionally, small-joint synovitis may be seen. Patients usually experience stiffness that is particularly worse after rest and may prevent them from getting out of bed. These symptoms may be accompanied by fatigue, depression and weight loss.