Background/Purpose: The RADIAL study is aimed to evaluate the performance of a composite approach, based on clinical, laboratory and ultrasound (US) data in the differential diagnosis among the main inflammatory arthropathies and Osteoarthritis (OA). In this preliminary analysis, based on partial data, we present the prevalence and the clinical characteristics of the patients affected by Calcium Pyrophosphate Deposition (CPPD) as diagnosed by US.

Methods: The RADIAL study is a multicenter, international, mixed design (retrospective, cross-sectional, prospective) diagnostic accuracy study. Consecutive patients reaching the rheumatology outpatients clinic for the first time, with suspicion of an inflammatory arthropathy, aged 18 or older and with recent standard blood exams were enrolled in the study. All patients underwent a US examination of an extended set of target joints for the assessment of specific lesions for Rheumatoid Arthritis, Psoriatic Arthritis, Gout, CPPD, Polymyalgia Rheumatica and OA. Demographic and clinical data were also collected. The presence of typical deposits in at least one joint classified patient as affected by CPPD for this preliminary analysis. After the first visit, all patients entered in routine follow up and treatment strategies were adopted according to guidelines after the diagnosis was made. To increase certainty of the diagnosis, patients will be classified after one year of follow-up (ongoing at the time of submission). In this analysis, we assessed the prevalence of CPPD in the cohort of the RADIAL study, stratified by age and US findings.

Results: 550 patients were enrolled, 58.9% female with a mean age of 60.1 yo (±14.4). 57.8% of the patients were affected by CPPD (318/550) considering the entire cohort, with a mean age of 63 yo (±13.1), significantly higher when compared to no CPPD patients [mean age 56.2 yo (±15.3)]. Stratifying by ageing, the prevalence increases to 66.2% considering the patients older than 60 (188/284) and 73% considering 80 yo or older subjects (30/41). From the US point of view, patients with CPPD had a significantly higher inflammatory involvement of wrists and knees at US (both in grey scale and power Doppler assessment – p< 0.001) compared to patients with any other disease and no CPPD, while no differences have been emerged between CPPD and the other arthropathies about the comorbidities and the general clinical profile.

Conclusion: CPPD is commonly encountered in a routine rheumatological setting, reaching a prevalence of more than 65% in patients older than 60. Symptom attribution is challenging as many conditions may be associated and even a higher presence of synovitis in patients with CPPD cannot be unequivocally attributed to it. There is an impellent need to raise awareness on CPPD and its possible implications. We expect RADIAL study to supply additional data on these findings.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/preliminary-descriptive-analysis-of-the-radial-cohort-study-about-the-prevalence-and-the-clinical-characteristics-of-patients-with-cppd-in-daily-clinical-practice/