Crystalline Arthropathies: gout and pseudogout Flashcards
What is the common patient type for gout
40-60 year old males
Cause of gout
purine diet, kidney disease and alcohol consumption
What is tophi
gouts impact on the soft tissue
what is the presentation of tophaceous gout
chronic joint deformity/edema; no erythema, minimal pain
chalky white deposits notable on exam and +/- decreased ROM
What is the gold standard diagnostic test for gout
identification of MSU crystals in synovial fluid (arthrocentesis)
Treatment for acute cout
NSAIDS, Indomethacin, colchicine and steroids (pred)
treatment for chronic gout
colchicine, allopurinol/febuxostat, probenecid, PEGylated Uricase
what is PEGylated Uricase
last line - artificial enzyme that makes uric acid more water soluble for improved excretion. Can promote resorption of tophi, no kidney function requirement
infusion - refer to rheumatology
What is the typical patient population for psuedogout
older patients, F>M
what is the duration of psudogout
longer attacks and can last up to one month
What are the at risk populations for pseudogout
hyperparathyroidism
hemochromatosis
hypomagnesemia
hypophosophatemia
certain autoimmune disorders
what is the presentation of pseudogout
acute onset monoarticular jont pain and tenderness, some erythema and edema may be present - less prominent than gout
primarily in the knees and wrist
+/- limited ROM due to pain
what is the gold standard diagnosis for pseudogout
CPP crystals in synovial fluid
what is the treatment of pseudogout
same acute inflammation treatment as gout
colchicine can be useful for recurrent attacks - no other preventative treatments
what shape are gout crystals
spear shape
