Pseudogout Flashcards
what is pseudogout
microcrystal synovitis caused by deposition of calcium pryophosphate dihydrate crystals in the synovium
aka pyrophosphate crystal deposition disease
associations of pseudogout
increasing age
if younger pt - i.e. <60:
- haemochromatosis
- hyperparathyroidism
- low mg, low phosphate
- acromegaly, wilson’s
features of pseudogout
knee, wrist, shoulders
joint aspiration: weakly positive birefringent rhomboid-shaped crystals
x-ray: chondrocalcinosis
how is chondrocalcinosis seen in the knee
linear calcifications of meniscus and articular cartilage
mx of pseudogout
aspiration of joint fluid to exclude septic arthritis
nsaids or intraarticular/intramuscular/oral steroids
typical blood test profile of 1o hyperparathyroidism?
raised PTH
raised calcium
low phosphate (due to phosphaturic effect of pth)
what diseases is someone with hyperparathyroidism at risk of?
pseudogout
chondrocalcinosis
osteoporosis
osteitis
fibrosa cystica
renal stones (due to increased serum and urinary calcium)
what is someone with hypoparathyroidism at risk of?
ectopic soft tissue calcification
ocular effects of prolonged hypocalcaemia?
increased risk of cataracts
ocular effects of prolonged hypercalcaemia?
increased risk of corneal calcification
why is hyperparathyroidism a/w pseudogout?
increased serum calcium - results from excess PTH
why is HYPOphosphataemia a/w pseudogout?
low phosphate = less chance forming complex with calcium = more free ca = more likely to deposit
why is acromegaly a/w pseudogout?
increased bone turnover = more free ca
