Crystal Arthropathies Flashcards
What is gout?
Uric crystal deposition in joints
Gout risk factors
Male sex
Obesity
High purine intake
High alcohol intake
Family history
Diuretics
CVD
Kidney disease
Gout presentation
Single acute swollen hot painful joints
Typically affects base of big toe and thumb, and wrists
Gouty tophi
Subcutaneous uric acid crystal deposition- seen in fingers, elbows, and ears
What would be seen in joint aspiration in gout?
Needle shaped, negatively bifringent crystals
Made of monosodium urate
What is a condition that needs to be ruled out?
Septic arthritis due to similar presentation
Gout X-ray findings
Lytic lesions, punched out erosions
Acute gout treatment
NSAIDs and PPI for gastroprotection
Colchicine 2nd line
Oral steroids 3rd line
Prophylactic gout treatment
Xanthine oxidase inhibitor- allopurinol/febuxostat
Given few weeks after acute treatment
Lifestyle changes
What is pseudogout?
Deposition of calcium pyrophosphate crystals
Pseudogout Risk factors
OA
Haemochromatosis
Hyperparathyroidism
Pseudogout presentation
Can be asymptomatic
Rapid painful swollen stiff knee in older patients
Can also affect shoulders, hips, wrists
Pseudogout diagnosis
Exclude septic arthritis
Joint aspiration- rhomboid shaped positively bifringent crystals
Pseudogout X-ray findings
Calcium deposits in joint cartilage- thin white line in middle joint space
LOSS findings
Treatment for gout
No way to treat so treat conservatively
NSAIDs, colchicine Etc
Left untreated in asymptomatic cases
