Metabolic Arthropathies Flashcards
What are the 3 main metabolic arthropathies
- Gout
- CPPD
- HADD
What does gout deposit in jts/around jts
Monosodium urate
Risk factors of gout
- fam hx
- diets high in purine/meat
- diuretics
- ASA/niacine
- kidney disease
age, gender and onset clinically of gout
Males>females 20:1
->40yold
oset- middle of night/pre dawn
Clincial features of gout
acute onset of inflammatory arthritis
-Red hot swollen joint
50-80% at 1st MTP in foot (podagra)
Radiographic findings in gout
- very specific soft tissue swelling
- initial preservation of jt space
- Tophi of calc
- Over hanging margin sign
What other signs are there in gout that are also in other conditions (3)
Bursitis (RA, trauma)
Chondrocalcinosis (CPDD)
Spotty carpal (RA)
What is CPPD, age, gender,
CPPD crystals that present as calcification appear within cartilage, capsules, and STs
> 40-50
M=F
what is the presentation of CPPD
bilateral symetric/asymetric
3 clinical forms of CPPD
- Aysymptomatic (20%)
- Similar to DJD (60%)
- Pseudogout (20%)
X ray findings of CPPD (3) + mc
- Chondrocalcinosis (ca fibrocartilage + articular cartilage)
- Periarticular calcification
- Degenerative changes (VERY large subchondral cysts)
Where are the classic locations for CPPD
- Knees (meniscus)
- Wrists + hands (articular catilage, triangular fibrocartilage)
- Pubic symphysis
What conditions will you see the terry thomas sign
RA, CPPD, Trauma
What is HAAD
Calcific tendinosis
Where is the mc loc of HADD, etiologu
suprastinatus mc
-unkown etiology, insidious
Progression of HADD and imaging findings
- pre calcific- deposits but cant pick up on exral
- calcific
- Post calcific- likely have tendon tears etc
@ what stage will there likely be no response to conservative tx
Resting phase
What must you see in HADD of longus coli
-must see prevertebral swelling in addition to calcific density
(transient, typically ant to C1/2)
What is pelligrini steida
post traumatic ossificatiojn from MCL tear
