pseudogout Flashcards
define pseudogout
A type of arthritis where calcium pyrophosphate crystals are deposited in joints.
risk factors for psuedogout
- Advanced age
- Injury/previous joint surgery
- Hyperparathyroidism
- Haemochromatosis
- Hypomagnesaemia
- Hypophosphatemia
- Intercurrent infection
- diabetes
what are the 2 ways pseudogout is presented as
- typically presents asymptomatically and is incidentally picked up on an x-ray,
- t can present as monoarthritis (pain and swelling in a single joint) or as chronic pain and stiffness of a joint.
what is a typical acute presentation of a patient with pseudogout
a patient over 65 years old with a rapid-onset hot, swollen, stiff and painful knee (can occur in any joint)
signs and symptoms of psuedogout
- Acute Monoarthritis
- Acutely inflamed, swollen, warm, and tender joint
- Acute Systemic Illness
- Chronic Joint Disease
what disease must be excluded when investigating pseudogout
septic arthritis as it is a medical emergency
what is psuedogout treatment targeted at
managing the symptoms
3 treatment options for pseudogout
- NSAIDS (+PPI)
- Colchicine
- Intra-articular/oral steroids
are symptoms of pseudogout worse or milder compared to septic arthritis and goat
milder
2 investigations for pseudogout
- joint aspiration - diagnostic
- x ray signs
what does joint aspiration for pseudogout show
Fluid shows rhomboid calcium pyrophosphate crystals that are positively birefringent of polarised light. There are no bacteria present.
what does x ray for pseudogout show
Chondrocalcinosis (calcium deposits in the joint cartilage)
+LOSS mnemonic (see osteoarthritis)
do asymptomatic changes found on an x ray for pseudogout require treatment
no!
does psuedogout have a prevention drug
no
how to differentiate between gout and pseudogout regarding joints affected
gout - small joints
pseudogout - large joints (most commonly knee)
