Gout + pseudogout Flashcards
Where does gout most commonly occur?
great toe MTP
What is podagra?
foot trap’, is gout which affects the joint located between the foot and the big toe, known as the metatarsophalangeal joint.
What are tophi?
urate deposits which form in joints, cartilage, and bone
Three differentials for gout?
septic arthritis
pseudogout
haemarthrosis
Two causes of gout?
drugs reduced excretion (renal impairment, primary gout) increased cell turnover alcohol excess purine rich foods
Two drugs that can cause gout?
diuretics, NSAIDs, cytotoxics, pyrazinamide
Two conditions that gout as a result of increased cell turnover?
leukaemia, lymphoma, haemolysis, tumour lysis syndrome
Two foods rich in purine?
beef, pork, lamb, seafood
Two drug treatments for gout?
NSIADs
Colchicine
Name a condition in which colchicine is contraindicated
Renal impairment, use steroids instead
One conservative preventative measure for gout and one medical
conservative- lose weight, avoid alcohol excess
Allopurinol
Which type of crystals cause gout?
sodium urate crystal
What is another name for polyarticular gout?
crystal arthritis
Name two types of crystal arthritis
gout and CPPD- calcium pyrophosphate deposition disease
Two unmodificable risk factors for gout?
age, male, race, genetic factors, impaired renal function
What would you see in an aspirate due to gout?
blue pin needle crystals
How can you differentiate CPPD/psuedogout with gout?
less commonly affects 1st MTP (big toe) and most commonly seen in the knee, wrist, and shoulder
What are two differences between gout and pseudogout?
Gout- urate crystals+ needle shaped. Pseudogout- calcium pyrophosphate crystals + rhomboid shaped
What is the presentation of acute CPPD?
acute monoarthropathy of knee, wrist, hip
What is the presentation of chronic CPPD?
destructive changes like OA, can present as polyarthritis
Name an autoimmune condition is associated with pseudogout
Hypothyroidism
Hyperparathyroidism
Hereditary haemochromatosis
Wilson’s disease
Name a classic finding on xray in CPPD
osteophyte hook
Name a classic finding on xray in gout
tophi
