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. Affected structures feel tender, leading to restricted shoulder movement if diagnosis is delayed. Muscular pain is often diffuse and is aggravated by movement.