Crystal Arthropathies Flashcards
What is the salt found in gout?
Monosodium urate monohydrate
What gender is more affected by gout?
Males
What are some risk factors for gout?
- Obesity
- Metabolic Syndrome
- Diet
- Thiazide Diuretics
Gout
- Supersaturation of uric acid
- Crystal formation which activate immune system
- Trigger complement cascade which
recruits neutrophils - Phagocytosis by monocytes activates intracellular inflammasome
What is the most likely cause of gout, overproduction or under excretion?
Underexcretion
What are the 2 important enzymes on the urate synthesis pathway?
- Deaminase
- Xanthine Oxidase
Podagra
Typical pain of gout found in the big toe - acute involvement of 1st MTP
Calcium Pyrophosphate Deposition Disease is AKA….
Pseudogout
What are the joints most often involved in pseudo gout?
Knees and wrist
What population is pseudo gout seen in?
Older people
Chondrocalcinosis
Calcium crystal deposition in meniscus of the knee and triangular cartilage of the wrist
Milwaukee Shoulder
- Hydroxypatite associated destructive arthritis
- Elderly females with destruction of rotator cuff and glenohumeral joint
Polymyalgia Rheumatica
Autoimmue disorder that causes pain and stiffness in proximal joints and muscles
- Shoulders and hips, neck muscles can be affected
What disease is polymyalgia rheumatica associated with?
Giant Cell Arteritis
What gender is more affected by polymyalgia rheumatica?
Females
Fibromyalgia
Chronic widespread pain with 11 or more tender points - more likely in women
Tenosynovial Giant Cell Tumor
Most common benign neoplasm of the synovium and is associated with translocation fusing the promoter of the collagen 6A3 gene to the coding sequence of M-CSF - can be localized or diffuse
Synovial Chondromatosis
Multiple nodules of hyalgine cartilage within subsynovial connective tissue with the knee most commonly affected - benign
What are foods to avoid for gout patients?
- Red meat
- Beer
- Shellfish
- Beans
Allopurinol MOA
Xanthine oxidase inhibitor - decreases the uric acid generated
What is poodagra indicative of?
Gout
What is positive birefringence indicative of?
CPPD - pseudogout
What is negative birefringence indicative of?
Gout
What biologic anti-inflammatory can be used in pseudo gout?
Anti-IL1
Where can hydroxyapatite also be found?
In the tendons
What is the treatment for polymyalgia rheumatica?
Corticosteroids
What is a major trigger/cause of fibromyalgia?
Lack of sleep - decreases pain tolerance
What is the joint most likely affected by Tenosynovial Giant Cell Tumor?
Knee
What is seen on histology of tenosynovial giant cell tumors?
Multiple hemosiderin-laden
macrophages, osteoclast-like giant cells
