Crystal Disorders

Question 1

What are the two types of crystal disorders?

Answer 1

1. Gout

2. Pseudo-gout

Question 2

What is the general pathophysiology of crystal disorders?

Answer 2

1. Crystals deposit in joint
2. Neutrophils activated
3. Joint Inflammation

Question 3

What are the investigations for crystal disorders?

Answer 3

1. Joint aspiration:
   - Rapid Gram Stain, Culture, Antibiotic Sensitivity assay
   - Polarising Light Microscopy```

Question 4

What is gout?

Answer 4

Monosodium Urate Crystals

Question 5

What are the risk factors for gout?

Answer 5

Hyperuricemia

Question 6

What are the causes for gout?

Answer 6

1. Genetic tendency
2. ↑ Intake Purine Rich food
3. ↓ Excretion

Question 7

What are the investigations for gout?

Answer 7

1. Polarising Light Microscopy:
   - Needle Shaped MSU Crystals
   - Negative Birefringence

Question 8

What are the symptoms of gout?

Answer 8

1. Arthritis:
   - Commonly 1st MTP
   - Abrupt Onset
   - Extremely painful
   - Joint = red, warm, swollen, tender
   - Resolves spontaneously over 3-10 days
2. Tophi:
   - MSU deposits in Tissue

Question 9

What is pseudo-gout?

Answer 9

Calcium Pyrophosphate dihydrate Crystals

Question 10

What are the risk factors for pseudo-gout?

Answer 10

1. Background OA
2. Elderly Pt’s
3. Intercurrent Infection

Question 11

What are the investigations for pseudo-gout?

Answer 11

1. Polarising Light Microscopy:
   - Rhomboid Shaped CPPD Crystals
   - Slightly Positive Birefringence

Question 12

What are the symptoms of pseudo-gout?

Answer 12

1. Arthritis:
   - Commonly Knee
   - Abrupt Onset
   - Extremely painful
   - Joint = red, warm, swollen, tender