Crystal arthritis Flashcards
What is gout?
Is a type of crystal arthritis which is associated with high blood uric acid levels and urate crystal are deposited in the joint.
What is pseudogout?
Is another type of crystal arthritis caused by calcium pyrophosphate crystals, crystals are deposited in the joints
Risk factors of gout?
Male
obesity
high purine diet
alcohol
diuretics
kidney disease
family history
Diagnosis of gout?
Aspirated fluid from joint is taken and will show:
- no bacterial growth
- Needle shaped crystal
- monosodium urate crystal
Joint x-ray can show
- space between joint
- lytic lesions in the bone
- punched out erosions
Managment of gout?
First line - NSAIDS
Second line - Colchicine
Steroids can be considered
Prophylaxis of gout?
Allopurinol dont take until after an acute attack.
What psuedogout diagnosis?
Aspirated fluid is taken from the joint and will show:
- no bacterial growth
- calcium pyrophosphate crystal
- Rhomboid shaped crystal
X-ray will show:
- Chondrocalcinosis
- Loss of joint space
- Osteophytes
- Suberticular sclerosis
- Subcondral cyst
Managment of psuedogout?
Nsaids
Colchicine
Joint aspiration
steroid injections
oral steroids
Pathophysiology of psuedogout?
Increased amount of uric acid will precipitate into monosodium urate crystals
These then deposit in joints and cause inflammation + pain.
How would gout and psuedogout look?
Gout: Negatively bifringent
Psuedogout: positively bifringent
