pseudogout

Question 1

What are the risk factors?

Answer 1

Old age, hyperparathyroidism, haemachromatosis, hypophophataemia

Question 2

What tests would you do?

Answer 2

Polarised light microscopy, aspirate (to exclude septic arthritis as with gout), electron microscopy if available, XR

Question 3

What would polarised light microscopy show?

Answer 3

Rod shaped crystals and weakly positively bifringent

Question 4

What might the XR show?

Answer 4

Calcification of cartilage

Question 5

What are the clinical features of pseudogout?

Answer 5

Rapidly developing severe pain, stiffness, swelling and overlying erythema,

Question 6

What are the signs of pseudogout?

Answer 6

Joint tenderness, effusion, fever, confusion

Question 7

What joints does pseudogout usually affect?

Answer 7

Only large joints esp knee. Wrist, shoulder, elbow and ankle may be affected

Question 8

Pseudogout is the most common cause of what?

Answer 8

Acute monoarthropathy in elderly

Question 9

Management?

Answer 9

Treat triggers, paracetamol, NSAIDs, joint aspiration, intra-articular steroid injections

Self-limiting should resolve in 1-2 weeks