MSK- crystal deposition diseases Flashcards
gout on synovial fluid analysis
needle-shaped negatively birefringent crystals of monosodium urate
pseudogout on fluid analysis
positively birefringent rhomboid-shaped crystals made of calcium pyrophosphate
indications for prophylactic therapy
- one or more attacks in year despite lifestyle modifications
- presence of gouty tophi or signs of chronic gout
- uric acid calculi
- chronic renal impairment
- heart failure where unable to stop diuretics
- chemo patients who develop gout
risk factors for pseudogout
elderly
osteoarthritis
injury/previous joint surgery
Hyperparathyroidism
Haemochromatosis
Hypomagnesaemia
Hypophosphataemia
Acute attacks may be precipitated by intercurrent infection
what can give a definitive diagnosis of gout
joint aspiration
treatment of gout
1st line NSAIDs/colchicine/steroids
what is gout
form of arthritis caused by deposits of monosodium irate crystals in and around the joints, leading to an acute inflammatory response
risk factors for gout
age- rare under 20, decreases after 80
male sex
very rare in women before menopause (oestrogen is protective)
some evidence of genetic predisposition
triggers for gout
seafood/protein binges
chemotherapy
trauma and surgery
alcohol excess
intercurrent illness
medications that interfere with handling of uric acid (eg allopurinol)
most commonly affected joints in gout
MTP joint
knee
ankle
what is pseudogout
form of arthritis caused by deposits of calcium pyrophosphate crystals provoking an inflammatory response
what is calcific tendonitis
painful condition affecting the rotator cuff of the shoulder, due to a build up of calcium deposits within the tendons
calcific tendonitis typically affects which patients
age 30-60 years
women more commonly affected than men
which shoulder is most commonly affected in calcific tendonitis, right or left?
right shoulder more commonly affected than left
