Hemochromatosis (skeletal manifestations)

Last revised by Daniel J Bell on 14 Oct 2022

Hemochromatosis is a systemic disease which affects many organs systems, including the joints, characterized by hemosiderin and calcium pyrophosphate deposition.

For a general discussion, and for links to other system specific manifestations, please refer to the article on hemochromatosis

  • chondrocalcinosis: particularly knees and triangular fibrocartilage
  • arthropathy
    • symmetrical loss of joint space, subchondral cysts 
    • close association with calcium pyrophosphate deposition disease (CPPD) which is often seen concurrently
    • most commonly hands (MCP, carpal, PIP) with the characteristic hook-like (or drooping or beak-like) osteophytes projecting from radial ends of 2nd and 3rd metacarpals
      • more extensive involvement from the second to the fifth MCP and radial hook-like osteophytes are more characteristic than in CPPD 3
      • hook-like osteophytes may also be seen at ulnar aspect
    • can also affect the knee, hip, and elbow
  • generalized osteoporosis (~25%) or osteopenia (~40%) 4

On imaging consider:

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