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A case of cerebrotendinous xanthomatosis without hyperlipidaemia but with tendinous scanthomatosis, subtle neurological disorders and endocrine cataract is reported. Accumulation of cholestanol, a cholesterol derivative, was detected by mass fragmentography. The plasma cholestanol : cholesterol ratio was 30 times higher than normally. Treatment with chenodesoxycholic acid during 26 months brought about neurological improvement, stabilization of the cataract and xanthomatosis and return to normal of plasma cholestanol levels.

A study was made of 45 patients suffering from hydroxyapatite rheumatism (multiple tendon calcifications disease). There were 36 women and 9 men aged between 15 and 61 years with an average age of 14. The following joints were involved (the first figure refers to clinical affection, that between brackets to radiologically demonstrable calcifications): shoulder 34 (36); neck 14 (15); wrist 18 (11); fingers 19 (17); hip 11 (29); knee 14 (18); ankle 10 (14); foot 5 (6); spinal column 16 (24). In 30 patients the disease manifested itself in the form of acute recurrent migratory arthritis resembling gout. In 8 cases, it developed in the form of acute recurrent migratory arthritis resembling gout. In 8 cases, it developed in the form of acute polyarthritis and in 7 as rheumatoid arthritis without radiological lesions. Thirty-two patients could be followed up. Four of them were cured, 9 showed improvement but still suffered attacks of pain. Eighteen patients were not improved, their pains growing more chronic. Four patients had a family history of multiple tendon calcifications disease.

Chondrocalcinosis is an arthropathy caused by deposits of calcium pyrophosphate-dihydrate microcrystals (CPPD) in the joints and occasionally in the tendons and ligaments. In our region it is almost always seen in its sporadic form in elderly subjects. The patients can be without symptoms or present four different clinical entities: an acute arthritis which can resemble and even be mistaken for an attack of gout or a septic arthritis; an inflammatory polyarthritis suggesting a rheumatoid arthritis; most frequently it appears as a benign polyarthrosis; sometimes it runs a destructive course capable of seriously damaging one or several joints. In certain cases chondrocalcinosis is associated with another metabolic disease. Familial forms have been described in some countries. Factors which induce the formation of the deposits of CPPD in the articular cartilages, fibrocartilages, the synovium and occasionally in the tendons and ligaments remain obscure. In contrast to urate gout, chondrocalcinosis appears to be due to a disturbance of pyrophosphate metabolism localized almost exclusively in the articular region. Its association with polyarthrosis rather frequently leads to destructive arthropathies. No etiological treatment for chondrocalcinosis exists at the present time. Therapy is limited to the administration of nonsteroidal antiinflammatory drugs and physiotherapy.