Crystal arthropathies Flashcards
What is gout?
Crystal arthropathy because of hyperuricaemia
Caused by deposition of urate within joints
Name 3 causes of hyperuricaemia
Excess consumption e.g. of alcohol
Over production e.g. haemolytic disorders, psoriasis
Reduced excretion e.g. renal impairment, diuretics
What is uric acid/urate?
The final compound in the breakdown of purines in DNA metabolism (A and G)
Which sex is more affected by gout?
Males
- incidence in women rises after menopause
What is the most common site for acute gout to present?
Which 2 are the next most common?
1st metatarso-phalangeal joint
- ankle
- knee
What is chronic tophaceous gout?
Chronic gout
Associated with diuretics
Pronounced swellings (tophi) seen
What is the gold standard investigation for gout?
Polarising microscopy of synovial fluid
- positive finding looks like starry sky
How else may you check for gout? (4)
X ray
Serum urate levels
Inflammatory markers
Renal function tests
Which 3 treatments can be used for acute gout?
NSAIDs
Colchine
Steroids (oral or intra-articular)
Which 2 drugs may be used for gout prophylaxis?
Allopurinol OR
Feuxostat
What is pseudogout?
Crystal arthropathy related to OA
Caused by deposition of calcium pyrophosphate crystals
Characterised by chondrocalcinosis
What is chondrocalcinosis?
Calcium pyrophosphate deposition in cartilage and other soft tissues, without acute inflammation
Which 3 areas does pseudogout commonly affect?
Knees
Wrists
(Ankles)
How is pseudogout treated?
NSAIDs
Colchicine
Steroids
Rehydration
What is Hydroxyapatite?
“milwaukee shoulder”
Hydroxyapatite deposition in and around joint
Acute and rapid
Females btwn 50-60
