Crystal arthropathies

Question 1

What findings would you expect to see on synovial fluid analysis in gout?

Answer 1

Needle shaped crystsals

Negatively biperfringent

Question 2

What are the complications of gout?

Answer 2

Nephrolithiasis -> renal impairment
Join destruction
Acute flare

Question 3

What are the risk factors for gout?

Answer 3

Increased age
Male sex
Consumption of meat, seafood and alcohol
Aspirin
Ciclosporin
Tacrolimus
Pyrazinamide
Genetics

Question 4

What are the potential causes of gout?

Answer 4

Under excretion of crate - renal failure, medications (aspirin, thiazides), von geirke disease
Over production of rate - increased consumption, tumour lysis syndrome, leach nyham syndrome

Question 5

What investigations should be conducted in suspected gout?

Answer 5

Atherocentesis
Synovial fluid analysis
Radiography
Serum uric acid level
Ultrasound
Dual energy CT

Question 6

Describe the management of pseudo gout?

Answer 6

Intra-articular steroids
NSAIDs
2nd line - colchicine

Long-term joint replacement may be required

Question 7

What sign may be seen on ultrasound in pseudo gout?

Answer 7

Double contour sign

Question 8

What sign may be seen on x-ray in pseudo gout?

Answer 8

Costochondrosis

Question 9

What findings would you expect to see on synovial fluid analysis in pseudogout?

Answer 9

Rhomboid crystal

Positively bifringent