Pseudogout (crystal arthropathy) Flashcards
Define pseudogout
Arthritis associated w/ deposition of calcium pyrophosphate dihydrate (CPPD) crystals in joint cartilage
Aetiology of pseudogout
4
CPPD crystal formation is initiated in cartilage located near the surface of chondrocytes
Linked w/ excessive calcium pyrophosphate production —> formation of CPPD crystals
Shedding of crystals into joint cavity leads to acute arthritis
Most causes of joint damage predispose to pseudogout (e.g. osteoarthritis, trauma)
Rarer conditions increasing risk of pseudogout
4
Haemochromatosis
Hyperparathyroidism
Hypomagnesaemia
Hypophosphatasia
Precipitating factors for pseudogout
3
intercurrent illness
surgery
local trauma
Epidemiology of pseudogout
gender, age
2x more common in WOMEN
More common in elderly
Presenting symptoms of pseudogout
3 types
Acute arthritis
Chronic arthropathy
Uncommon presentations
Presenting symptoms of pseudogout - acute arthritis
2
Painful Swollen joint (e.g. knee, ankle, shoulder, elbow, wrist)
Presenting symptoms of pseudogout - chronic arthropathy
3
Pain
Stiffness
Functional impairment
Presenting symptoms of pseudogout - uncommon
3
Tendonitis
Tenosynovitis
Bursitis
Signs of pseudogout on physical examination - acute arthritis
(5)
Red Hot Tender Restricted range of movement Fever
Signs of pseudogout on physical examination - chronic arthropathy
(5)
Similar to osteoarthritis Bony swelling Crepitus Deformity Restriction of movement
Investigations for pseudogout
3 types
Bloods
Joint aspiration
Plain radiograph of joint
Investigations for pseudogout - bloods
3
High WCC in acute attacks
High ESR
Blood culture - to exclude septic arthritis
Investigations for pseudogout - joint aspiration
3
Rhomboid, brick shaped crystals
POSITIVE birefringence
Culture or gram staining to exclude septic arthritis
Investigations for pseudogout - plain radiograph of joint
5
Chondrocalcinosis Signs of osteoarthritis loss of joint space osteophytes subchondral cysts sclerosis
