Pseudogout Flashcards
Pseudogout is a crystal arthropathy caused by what kind of crystals collecting in the joints?
Calcium pyrophosphate crystals
What are other names for pseudogout?
Calcium pyrophosphate deposition disease (CPDD)
or Chondrocalcinosis
Can pseudogout ever be asymptomatic?
Yes, it can be picked up incidentally on an X-ray
What is a typical acute presentation of pseudogout?
65+ y/o with a rapid-onset hot, swollen, stiff and painful knee.
What joints are commonly affected by psuedogout?
Knee
Shoulder
Hip
Wrist
What must be excluded in a patient presenting with a hot, painful, swollen joint?
Septic arthritis (symptoms tend to be more severe than psuedogout)
How do you confirm a diagnosis of pseudogout?
Joint aspiration showing calcium pyrophosphate crystals.
What are the features of calcium pyrophosphate cystals?
Rhomboid shape
Positively birefringent of polarised light
How does pseudogout show up on an X-ray?
Calcium deposits in the joint cartilage show as a thin white line in the middle of the joint space.
Called chondrocalcinosis
What other X-ray changes can be seen in pseudogout which are shared with osteoarthritis?
LOSS
Loss of joint space
-> Osteophytes
Subchondral sclerosis (increased bone density along joint line)
-> Subchondral cysts (fluid-filled holes in bone)
Do asymptomatic cases of pseudogout need treatment?
No
Symptoms of pseudogout usually resolve spontaneously over several weeks. What symptomatic management options are available?
1st line:
NSAIDs with PPI
Colchicine
Intra-articular steroid injections
Oral steroids
