Clin - Gout and Pseudogout

Question 1

compare signs/sx of acute and chronic gout

Answer 1

acute:
- pain, redness, warmth, swollen
- often occurs at night
- has triggering events (red meats/seafood/purines/alcohol/trauma)

chronic:

• tophi (ears, forearms, achilles tendon)
• renal insufficiency

Question 2

where does pseudogout occur and in what patients

Answer 2

large joints like the knee

older patients

Question 3

sx of pseudogout

Answer 3

can be polyarticular, warm, swollen, red, painful

if chronic - resembles OA

Question 4

what is chondrocalcinosis and what does it occur in

Answer 4

calcium deposits in the articular cartilage

pseudogout

Question 5

describe the appearance of pseudogout crystals (calcium pyrophosphate dehydrate deposition dz) and how they appear on polarizing microscopy

Answer 5

short, blunt rods, rhomboids/cuboids

weak POSITIVE birefringence

Question 6

in younger patients who have sx of pseudogout, what should be on your list of ddx

Answer 6

• primary hyperparathyroidism
• hemochromatosis
• hypomangesemia
• chronic gout
• gitelman’s syndrome

Question 7

treatment for pseudogout

Answer 7

• NSAIDs
• steroids (intra-articular injections)
• colchicine (variable)