Rheumatology - Pseudogout

Question 1

What is pseudogout?

Answer 1

Crystal arthropathy caused by calcium pyrophosphate

Question 2

How does pseudogout present?

Answer 2

Asymptomatic
Picked up incidentally on x-ray

May have chronic pain and stiffness in multiple joints

Question 3

How does pseudogout typically present?

Answer 3

Patient over 65
Rapid-onset hot, swollen, stiff and painful knee

Question 4

How do symptoms of pseudogout compare to gout and septic arthritis?

Answer 4

Tend to be milder

But must exclude septic arthritis

Question 5

What is used to confirm pseudogout diagnosis?

Answer 5

Joint aspiration

Calcium pyrophosphate crystals
Rhomboid-shaped
Positively birefringent of polarised light

Question 6

What is the classical x-ray change in pseudogout?

Answer 6

Chondrocalcinosis

Calcium deposits in joint cartilage

And LOSS

Question 7

How is pseudogout managed?

Answer 7

Targeted at symptoms
NSAIDs
Colchicine
Intra-articular steroid injections
Oral steroids