MSK- crystal deposition diseases

Question 1

gout on synovial fluid analysis

Answer 1

needle-shaped negatively birefringent crystals of monosodium urate

Question 2

pseudogout on fluid analysis

Answer 2

positively birefringent rhomboid-shaped crystals made of calcium pyrophosphate

Question 3

indications for prophylactic therapy

Answer 3

1. one or more attacks in year despite lifestyle modifications
2. presence of gouty tophi or signs of chronic gout
3. uric acid calculi
4. chronic renal impairment
5. heart failure where unable to stop diuretics
6. chemo patients who develop gout

Question 4

risk factors for pseudogout

Answer 4

elderly
osteoarthritis
injury/previous joint surgery
Hyperparathyroidism
Haemochromatosis
Hypomagnesaemia
Hypophosphataemia
Acute attacks may be precipitated by intercurrent infection

Question 5

what can give a definitive diagnosis of gout

Answer 5

joint aspiration

Question 6

treatment of gout

Answer 6

1st line NSAIDs/colchicine/steroids