200 Section - Platelet Rich Plasma Injection Triggering Pseudogout Flare: An Uncommon Therapeutic Complication

Calcium pyrophosphate dihydrate deposition disease (CPPD) is a crystal-induced arthropathy caused by the deposition of calcium pyrophosphate crystals within joint cartilage, most commonly affecting older adults and large joints such as the knee. Acute CPPD flares may be precipitated by physiologic stressors including intra-articular interventions. PRP injections are increasingly utilized for osteoarthritis management due to their proposed regenerative and anti-inflammatory effects; however, their role as a trigger for crystal arthropathy remains poorly described. In this case, the temporal relationship between PRP injection and symptom onset, along with synovial fluid analysis consistent with CPPD, supports PRP as a potential precipitating factor for an acute pseudogout flare. Local inflammatory responses induced by PRP, changes in the intra-articular milieu, or mechanical disruption during injection may contribute to crystal shedding and subsequent inflammation.

Conclusions:

This case highlights PRP injection as a rare yet clinically important potential trigger for acute pseudogout. As the use of PRP continues to expand in the management of osteoarthritis, clinicians should remain vigilant for CPPD flares, particularly in patients with known crystal arthropathy. Acute joint symptoms following PRP injection should prompt consideration of a CPPD flare, as early recognition and appropriate diagnostic evaluation are essential to ensure timely diagnosis and effective management.