Calcification of cartilage, or chondrocalcinosis, may be seen in a variety of disorders and may involve fibrocartilage or hyaline cartilage. In addition, chondrocalcinosis may be present in the absence of joint symptoms or abnormalities (estimated at over 20% of involved patients) or may be associated with the development of acute arthritis attacks (pseudogout) or chronic arthritis (crystalline arthropathy) as well as other less common manifestations. Chondrocalcinosis is most frequently associated with idiopathic calcium pyrophosphate dihydrate (CPPD) crystal deposition in which it may involve both the fibrocartilage structures such as the menisci of the knees, pubic symphysis and the triangular fibrocartilage of the wrist as well as involvement of hyaline cartilage where the mineralization parallels the articular surface of bones. In addition to CPPD, chondrocalcinosis may be present with hyperparathyroidism, hemochromatosis or Wilson disease to name just a few. A high association between CPPD and gout exists. Up to 8% of patients with CPPD crystal deposition will also have concurrent gout making acute arthritis attacks secondary to gout in the presence of chondrocalcinosis difficult to differentiate from pseudogout attacks. Luckily, both respond to cholchicine treatment and differentiation by polarized light microscopy of a joint aspirate may be helpful.