Do you avoid hyaluronic acid injections in patients with chondrocalcinosis on imaging?  

The association between viscosupplementation and CPPD flares is reported but not truly well studied. There is a nice case series by Bernardeau et al., PMID 11302877 entitled “Acute arthritis after intra-articular hyaluronate injection: onset of effusions without crystals” in Ann Rhe...

I agree with @Paul J. DeMarco and @Donald E. Thomas, as I offer the HA injections to patients even if there is evidence of CPPD on imaging or prior fluid aspirations.  I do not recall any of my patients reporting the swelling/reactions following HA since I stopped using Synvisc years ago - and...