Confusion With Presentations of Calcium Pyrophosphate Dihydrate Disease: A Report of Two Cases Mistaken for Cellulitis

Abstract

Both pseudogout and cellulitis are diseases that may mimic one another in clinical practice. We discuss two cases of acute calcium pyrophosphate dihydrate (CPPD) arthritis mistaken for cellulitis in the emergency department. Both patients experienced significant improvement after management was changed to treat CPPD. These cases highlight how it is essential for physicians to consider CPPD as a differential diagnosis for a patient that is presenting with signs of inflammation in any joint.

An unusual case of acute pseudogout in the hand masquerading as cellulitis

“…A nal diagnosis of acute chondrocalcinosis was made by the visualization of positive birefringent rhomboid-shaped crystals in the wrist joint synovial uid. Masooma et al [7] reported two cases of acute calcium pyrophosphate dihydrate arthritis mistaken for cellulitis. In our patient, based on clinical signs and symptoms, previous history of the left forearm with hand swelling (the speci c details are unknown), and laboratory parameters, an initial diagnosis of hand cellulitis was made.…”