Others Flashcards
what is gout
inflammation of the joint trigger by uric acid crystals
what results in crystalisation
hyperuricemia
what are causes of hyperuricaemia
Increased urate production
Reduced urate excertion
what can cause increased urate production
psoriasis
haemolytic disorders
alcohol
high dietary purine intake (red meat/sea food)
what can cause reduced urate excretion
chronic renal impairment
heart failure
hypothyroidism
diuretics
presentation of acute gout
usually affects 1 joint (1st MTP, ankle, knee) abrupt onset, often over night severe pain joint stiffness joint swelling/effusion tophi
treatment of acute gout
NSAIDS
Colchicine
Corticosteroids
what is a tophi
deposit of crystalline uric acid and other substances at the surface of joints or in skin or cartilage
what is treatment for recurrent gout i.e. prophylaxis
Allopurinol
Febuxostat
Start 2-4 weeks after acute attack
investigations of gout
serum uric acid levels - will be raised inflammatory markers - will be raised Polarising microscopy of synovial fluid x-ray of affected joint US - to look for tophi or erosions
what is Calcium pyrophosphate deposition disease
deposition of calcium pyrophosphate (CPP) crystal in the joints
What is CPDD also known as
pseudogout
what is CPDD associated with
Hyperparathyroidism Hypercalcemia Hypothyroidism Gout Aging
treatment of CPPD
Intra-articular Corticosteroids (if possible)
1st line NSAIDs
2nd line Colchicine
what is the cause of a “Milwaukee shoulder” on an x-ray
Hydroxyapatite crystal deposition in or around the joint.
what happens in ‘Milwaukee shoulder’ and who gets it
Release of collagenases, serine proteinases and IL-1
Acute and rapid deterioration.
Females, 50-60 years
Tx for Milwaukee shoulder
NSAIDs
Intra-articular steroid injection
Physiotherapy
Partial or total arthroplasty
what is soft tissue rheumatism
General term to describe pain that is caused by inflammation/damage to ligaments, tendons, muscles or nerve near a joint rather than either the bone or cartilage
what are features of soft tissue rheumatism
pain should be confided to a specific site e.g. shoulder, wrist
who gets joint hyper mobility syndrome
females > males
genetic conditions - Marfan’s
what is used to assess hyper mobility and how is it treated
Modified Beighton Score
Physiotherapy
what does hyper mobility typically present with
arthralgia; joint pain
premature OA
what is a score of hyper mobility in the Modified Beighton Score
more than 6 out of 9
