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This case illustrates radiographic findings of CPPD and explores the challenges of treating CPPD in the setting of comorbid conditions.<\/jats:p>","DOI":"10.1136\/bcr-2018-226132","type":"journal-article","created":{"date-parts":[[2018,9,29]],"date-time":"2018-09-29T02:45:54Z","timestamp":1538189154000},"page":"bcr-2018-226132","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Severe calcium pyrophosphate dihydrate deposition disease of the metacarpophalangeal joints"],"prefix":"10.1136","volume":"2018","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6914-7663","authenticated-orcid":false,"given":"Cody A","family":"Rigsbee","sequence":"first","affiliation":[{"name":"Medicine\/Rheumatology, University of Kentucky, Lexington, Kentucky, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Travis C","family":"Sizemore","sequence":"additional","affiliation":[{"name":"Medicine\/Rheumatology, University of Kentucky, Lexington, Kentucky, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kristine M","family":"Lohr","sequence":"additional","affiliation":[{"name":"Medicine\/Rheumatology, University of Kentucky, Lexington, Kentucky, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2018,9,28]]},"reference":[{"key":"2025082805153687000_2018.sep28_1.bcr-2018-226132.1","doi-asserted-by":"crossref","first-page":"2575","DOI":"10.1056\/NEJMra1511117","article-title":"Calcium Pyrophosphate Deposition Disease","volume":"374","author":"Rosenthal","year":"2016","journal-title":"N Engl J Med"},{"key":"2025082805153687000_2018.sep28_1.bcr-2018-226132.2","doi-asserted-by":"crossref","first-page":"39","DOI":"10.2147\/OARRR.S39039","article-title":"Calcium pyrophosphate crystal deposition disease: diagnosis and treatment","volume":"6","author":"Rosales-Alexander","year":"2014","journal-title":"Open Access Rheumatol"},{"key":"2025082805153687000_2018.sep28_1.bcr-2018-226132.3","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1097\/BOR.0000000000000246","article-title":"Calcium pyrophosphate deposition disease: a review of epidemiologic findings","volume":"28","author":"Abhishek","year":"2016","journal-title":"Curr Opin Rheumatol"},{"key":"2025082805153687000_2018.sep28_1.bcr-2018-226132.4","doi-asserted-by":"publisher","DOI":"10.1186\/ar4453"},{"key":"2025082805153687000_2018.sep28_1.bcr-2018-226132.5","doi-asserted-by":"crossref","first-page":"1052","DOI":"10.1002\/acr.21952","article-title":"Evidence of a systemic predisposition to chondrocalcinosis and association between chondrocalcinosis and osteoarthritis at distant joints: a cross-sectional study","volume":"65","author":"Abhishek","year":"2013","journal-title":"Arthritis Care Res"},{"key":"2025082805153687000_2018.sep28_1.bcr-2018-226132.6","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1097\/00003086-198804000-00023","article-title":"Clinical features of pseudogout attack. 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