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MSK > Crystal Arthopathy > Flashcards

Crystal Arthopathy Flashcards

1
Q

What are crystal arhopathies?

A

Characterised by deposition of mineralised material within joints and peri-articular tissue

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2
Q

What are some common crystal arhopathies?

A

Gout (monosodium urate)

Pseudogout (calcium pyrophosphate dihydrate (CCPD))

Calcific periarthritis / tendonitis (BCP)

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3
Q

What is a tophus or tophi?

A

Massive accumulation of uric acid

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4
Q

Why do people with gout have hyperuricaemia?

A

Purines broken down to uric acid, which is excreted in the kidney

Reduced renal urate clearancy = hyperuricaemia

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5
Q

What causes over production of uric acid?

A 
Malignancy
Severe exfoliative psoriasis
Drugs
Metabolic errors
HGPRT defficiency
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6
Q

What causes under excretion of uric acid?

A 
Renal impairment
Hypertension
Hypothyroidism
Drugs (alcohol, aspirin, diuretics, cyclosporin)
Exercise, starvation, dehydration
Lead poisoning
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7
Q

What is Lesch-Nyan Syndrome?

A

HGRPT deficiency
X linked

Disability - aggressive and impulsive
Gout
Renal disease

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8
Q

How do you diagnose gout?

A

Aspiration and analysis

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9
Q

What is the management of gout?

A

Acute flare

  • NSAID’s
  • Colchicine
  • Steroids

Dont treat if asymptomatic

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10
Q

How to lower uric acid?

A

Xanthine oxidase inhibitor - allopurinol
Febuxostat
Uricosuric agents
Canakinumab

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11
Q

What is pseudogout?

A

Made of calcium not uric acid
Commonly in older female knees
-Idiopathic, familial or metabolic cause

Triggers = trauma or intercurrent illness

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12
Q

What is the management of psuedogout?

A

NSAID’s

Inraarticular steroids

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13
Q

What is polymyalgia rheumatica?

A

Inflammatory condition of the elderly

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14
Q

What condition does polymyalgia rheumatic closely associated with?

A

Giant cell arteritis

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15
Q

What are the symptoms of polymyalgia rheumatica?

A

Sudden onset of shoulder or pelvis
Anaemia
Malaise, weight loss, fever and depression

Arthralgia and synovitis occasionally

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16
Q

How to diagnose polymyalgia rheumatica?

A

Compatible history
Age = >50
ESR >50
Dramatic steroid response

No specific diagnostic test

17
Q

DD of polymyalgia rheumatica?

A 
Inflammatory joint disease
Underlying malignancy
Inflammatory muscle disease
Hypo / hyper-thyroidism
Bilateral shoulder capsulitis 
Fibromyalgia
18
Q

Treatment of polymyalgia rheumatic?

A

Prednisolone for 18-24 months

Bone prophylaxis

MSK (21 decks)

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