Since the original descriptions of the involvement of crystals in arth
ritis, understanding of the clinical syndromes of gout and pseudogout
and the role of basic calcium crystals in arthritis has increased. Gou
t is a common problem in middle-aged males but has an increasing preva
lence in older patients, particularly women. Calcium pyrophosphate dih
ydrate (CPPD) crystal deposition disease is now a well-recognized prob
lem in older patients. The diagnosis of both of these common forms of
arthritis and the need to individualize therapy in patients with other
medical problems remain important clinical challenges to the practici
ng physician.ell-recognized problem in older patients. The diagnosis o
f both of these common forms of arthritis and the need to individualiz
e therapy in patients with other medical problems remain important cli
nical challenges to the practicing physician.