Pseudogout Flashcards
Define Pseudogout?
Arthritis associated with deposition of calcium pyrophosphate dihydrate (CPPD) crystals in the joint cartilage
What is the aetiology of Pseudogout?
CPPD crystal formation is initiated in cartilage located near the surface of chondrocytes
It is linked with excessive calcium pyrophosphate production
This abudance of calcium pyrophosphate leads to the formation of CPPD crystals
Shedding of crystals in to the joint cavity leads to acute arthritis
Most causes of joint damage predispose to pseudogout (e.g. osteoarthritis, trauma)
What are the rarer conditions that increase the risk of Pseudogout?
Haemochromatosis
Hyperparathyroidism
Hypomagnesaemia
Hypophosphatasia
What are the precipitating factors for Pseudogout?
Intercurrent illness
Surgery
Local trauma
What is the epidemiology of Pseudogout?
2x more common in WOMEN
More common in the ELDERLY
What are the presenting symptoms of Acute Arthritis on Pseudogout?
Painful Swollen joint (e.g. knee, ankle, shoulder, elbow, wrist)
What are the presenting symptoms for Pseudogout on chronic arthropathy?
Pain
Stiffness
Functional impairment
What are the Uncommon presentations of Pseudogout?
Tendonitis
Tenosynovitis
Bursitis
What are the signs of Acute Arthritis in Pseudogout on physical examination?
Red Hot Tender Restricted range of movement Fever
What are the signs of Chronic Arthopathy in Pseudogout?
Similar to osteoarthritis Bony swelling Crepitus Deformity Restriction of movement
What bloods would you do for Pseudogout?
High WCC in acute attacks
High ESR
Blood culture - to exclude septic arthritis
What do we see on Joint Aspiration for Pseudogout?
Rhomboid, brick-shaped crystals
Positive birefringence
Culture or Gram-staining to exclude septic arthritis
What do we see on a Plain radiograph of the joint on Pseudogout?
Chondrocalcinosis
Signs of osteoarthritis
What are the signs of osteoarthritis you see in Pseudogout?
Loss of joint space
Osteophytes
Subchondral cysts
Sclerosis
