Pseudogout

Question 1

What is pseudogout

Answer 1

Inflammation of joints caused by deposition of calcium pyrophosphate crystals in articular and peri-articular tissue

Question 2

Who is most commonly affected by pseudogout

Answer 2

Elderly

Question 3

What are some precipitants for pseudogout

Answer 3

Dehydration
Intercurrent illness
Hyperparathyroidism
Hypomagnesaemia
Long-term steroid use

Question 4

Which joints are commonly affected

Answer 4

Knee - most common

Can also affect wrists, shoulders, hands and feet

Question 5

What are the clinical features of pseudogout

Answer 5

Acute joint inflammation:
Swelling
Erythema
Warm

Question 6

What diagnostic investigations could you do for this patient

Answer 6

X-ray
US
Synovial fluid aspiration

Question 7

What would you expect to find on X-ray of a patient with pseudogout

Answer 7

Linear opacification of articular cartilage

Question 8

What would you expect to find on US of a patient with pseudogout

Answer 8

Calcified deposits in articular tissues

Question 9

What would you expect to find on synovial fluid aspiration of a patient with pseudogout

Answer 9

Positively birefringent rhomboid-shaped crystals under polarised light

Question 10

How would you manage a patient with pseudogout

Answer 10

Conservative:
Ice packs
Rest

Medical:
NSAIDs
Intra-articular steroid injections
Systemic steroids - if treatment failure/contraindication