Pseudogout

Question 1

What is pseudo gout ?

Answer 1

calcium pyrophosphate crystal deposition in synovium

Question 2

underlying risk factor for pseudo gout ?

Answer 2

haemochromatosis

hyperparathyroidism

low magnesium, low phosphate

acromegaly, Wilson’s disease

Question 3

Clinical features of pseudo gout

Answer 3

Monoarthritis Joint

Wrist / shoulder and knees commonly affected

erythematous, tender and swollen with a restricted range of motion.

Question 4

Diagnosis of pseudo gout to gout

Answer 4

Pseudogout and gout both have mono arthritis

X ray
Calcification of cartilage suggests chondrocalcinosis- prominent calcification of the menisci and articular cartilage

joint aspiration: weakly-positively birefringent rhomboid-shaped crystals
Lack of crystals on microscopy would not rule these out

Question 5

Management of pseudoarthritis

Answer 5

aspiration of joint fluid, to exclude septic arthritis
NSAIDs or intra-articular, intra-muscular or oral steroids as for gout