Crystal Arthropathy: Pseudogout Flashcards
What is pseudogout?
A crystal arthropathy caused by calcium pyrophosphate crystals collecting in the joints
Also known as calcium pyrophosphate deposition disease (CPPD) and may be called chondrocalcinosis.
What is the typical age of patients presenting acutely with pseudogout?
Over 65 years old
What are common joints affected by pseudogout?
Knee, shoulders, hips, wrists
What is the first step in diagnosing a hot, painful, and swollen joint?
Exclude septic arthritis
What is the characteristic finding in joint fluid for diagnosing pseudogout?
Calcium pyrophosphate crystals
How do calcium pyrophosphate crystals appear under polarized light?
Rhomboid-shaped and positively birefringent
What x-ray change is classic in pseudogout?
Chondrocalcinosis
What does the ‘LOSS’ mnemonic stand for in relation to x-ray changes in pseudogout?
- Loss of joint space
- Osteophytes (bone spurs)
- Subarticular sclerosis (increased density of the bone along the joint line)
- Subchondral cysts (fluid-filled holes in the bone)
What is the primary goal of pseudogout management?
Targeted at symptoms
What is the first-line treatment for symptomatic management of pseudogout?
NSAIDs (e.g., naproxen)
What should be co-prescribed with NSAIDs for gastroprotection?
Proton pump inhibitor
What are alternative symptomatic management options for pseudogout?
- Colchicine
- Intra-articular steroid injections (after excluding septic arthritis)
- Oral steroids
True or False: There are proven disease-modifying drugs for pseudogout.
False
Fill in the blank: Asymptomatic changes on an x-ray do not require _______.
any treatment
How long do symptoms of pseudogout usually take to resolve?
Several weeks
