Pseudogout Flashcards
What is pseudogout?
Pseudogout, also known as calcium pyrophosphate deposition disease (CPPD) or chondrocalcinosis, is a crystal arthropathy caused by the deposition of calcium pyrophosphate crystals in the joints.
Pseudogout can lead to joint inflammation and pain similar to gout.
What is the most common joint affected in acute pseudogout?
The knee is the most commonly affected joint, especially in patients over 65 years old.
Older adults are at higher risk for developing pseudogout.
What are the common symptoms of acute pseudogout?
A rapid-onset, hot, swollen, stiff, and painful joint, typically in the knee. Other commonly affected joints include the shoulders, hips, and wrists.
Symptoms can mimic other forms of arthritis.
What must be excluded in any patient presenting with a hot, painful, and swollen joint?
Septic arthritis must be excluded, as it is a medical emergency.
Prompt diagnosis is crucial to prevent joint damage.
What is the diagnostic test for pseudogout?
Joint aspiration showing calcium pyrophosphate crystals, which are rhomboid-shaped and positively birefringent under polarised light.
This test helps distinguish pseudogout from other types of arthritis.
What does chondrocalcinosis look like on an x-ray?
A thin white line in the middle of the joint space, representing calcium deposits in the joint cartilage.
This radiographic finding is characteristic of pseudogout.
What other x-ray changes can be seen in pseudogout that are similar to osteoarthritis?
The ‘LOSS’ mnemonic:
* Loss of joint space
* Osteophytes (bone spurs)
* Subarticular sclerosis (increased bone density along the joint line)
* Subchondral cysts (fluid-filled holes in the bone)
These changes can complicate the diagnosis if not carefully evaluated.
What is the general management approach for pseudogout?
Symptomatic treatment is aimed at managing the pain and inflammation, as there are no proven disease-modifying treatments.
Management focuses on improving quality of life.
What are the first-line treatments for pseudogout?
NSAIDs (e.g., naproxen), co-prescribed with a proton pump inhibitor for gastroprotection.
This helps prevent gastrointestinal side effects associated with NSAIDs.
What are other treatment options for pseudogout if NSAIDs are insufficient?
Colchicine
Intra-articular steroid injections (septic arthritis must be excluded first)
Oral steroids
These options may help reduce inflammation and pain when NSAIDs are not effective.
How long does it typically take for symptoms of pseudogout to resolve?
Symptoms usually resolve spontaneously over several weeks.
However, recurrence is common, requiring ongoing management.
