Abstract
ObjectiveTo estimate the prevalence and incidence of non-gout crystal arthropathy in relation to socioeconomic factors in southern Sweden.MethodsAll patients (age ≥ 18 years) with at least one visit to a physician with the diagnosis of interest in the Skåne region (population of 1.3 million) in 1998–2014 were identified. Non-gout crystal arthropathy (ICD-10 codes M11.0–M11.9) was subclassified in four different groups: calcium pyrophosphate crystal deposition related arthropathy (CPPD), unspecified non-gout arthropathies, chondrocalcinosis, and hydroxyapatite crystal deposition disease. The crude and age-adjusted point prevalence on December 31, 2014, and the cumulative incidence during 2014 were calculated for all non-gout crystal arthropathies, CPPD, and other unspecified non-gout arthropathies overall and in relation to occupation, income, and level of education.ResultsThe crude 2014 point prevalence (95% CI) and 2014 cumulative incidence (95% CI) of all non-gout crystal arthropathies were 0.23% (0.23–0.24) and 21.5 (19–25) cases/100,000 persons. Mean age (range) among all prevalent cases in 2014 was 71 (20–102) years and 56% were males. The point prevalence and cumulative incidence of CPPD were 0.09% (0.08–0.09) and 8 (7–10)/100,000 persons, respectively. The corresponding data for unspecified non-gout crystal deposition disease was 0.16% (0.16–0.17) and 15.6 (13–18)/100,000 persons, respectively. The prevalence and incidence of CPPD and unspecified non-gout crystal arthropathies were slightly higher in men and increased with age irrespective of gender. Unspecified non-gout crystal arthropathy but not CPPD was less prevalent in persons with ≥ 15 years of education, whereas there were no clear associations with occupation and income.ConclusionThe prevalence of all diagnosed non-gout crystal arthropathies was 0.23%, thus considerably less prevalent than gout in southern Sweden. CPPD and other unspecified non-gout crystal arthropathies are the predominant diagnoses, increasing with age and in men. With the exception for unspecified non-gout crystal arthropathies being inversely correlated to a higher level of education, no convincing association with the socioeconomic factors was found.
Highlights
Crystal arthropathies excluding gout include acute and chronic calcium pyrophosphate, hydroxyapatite, and other related crystal deposition diseases
The mean age for a person diagnosed with non-gout crystal arthropathy in the year 2014 was 71 years (20–102) and 56% were men
The prevalence and cumulative incidence of patients diagnosed with unspecified non-gout crystal arthropathy were higher than that for Calcium pyrophosphate crystal deposition related arthropathy (CPPD) with a prevalence of 0.16% and an incidence of 15.6/100,000 persons
Summary
Crystal arthropathies excluding gout (non-gout crystal arthropathies) include acute and chronic calcium pyrophosphate, hydroxyapatite, and other related crystal deposition diseases. CPPD can be present clinically as CPPD-associated osteoarthritis, acute CPP crystal arthritis, or chronic CPP crystal arthritis [1, 2]. Hameed et al Arthritis Research & Therapy (2019) 21:291 form of CPPD is acute CPP crystal arthritis affecting knee joint, wrist, or shoulder in person older than 65 years (previously known as pseudogout). Chondrocalcinosis (CC), a usually asymptomatic CPPD commonly visualized on radiographs, supports the diagnosis but the identification of rhomboid, mostly intracellular calcium pyrophosphate crystals in the synovial fluid, is necessary for confirmation of diagnosis [1,2,3,4]. The incidence and prevalence of clinically diagnosed forms of CPPD disease are less well established
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