Septic crystal reactive arthropathy Flashcards
What are differentials of an acute hot joint?
Septic
Crystal
Trauma
Early presentation of polyarthropathy
What causes gout?
Excess urate deposition in joints, usually distal e.g. MTP big toe.
What causes high uric acid levels seen in gout?
Age, alcohol, high protein intake, diabetes
Primary disorders: Lesch Nyhan syndrome
Secondary disorders: MPD, chronic renal disease, use of diuretics,
How is gout diagnosed?
Joint aspirate polarised light microscopy shows negatively bifringent needle shaped crystals
What is acute and chronic gout?
Acute- inflammatory process in joints due to uric acid deposition.
Chronic- tophi formation
How is acute gout managed?
High dose NSAIDs
Colchicine
Corticosteroids
How are repeated attacks of gout managed?
Allopurinol/febuxostat- xanthine oxidase inhibitors
Probenecid - uricosuric agents which puts urate into urine
Rasburicase
What is pseudogout?
Calcium pyrophosphate crystal deposition
How is pseudogout diagnosed?
Polarised light microscopy shows positively bifringent rhomboid shaped crystals
How is pseudogout treated?
Acute: aspiration, NSAIDs + colchicine
Chronic: methotrexate/hydrochloroquine
What are causes of reactive arthritis?
Chlamydia, shigella, salmonella (mucosal)
What are signs of reactive arthritis?
Keratoderma blenorrhagica
Iritis, conjucitivitis, uveitis, mouth ulcers.
How is reactive arthritis treated?
NSAIDs, intra-articular steroids.
What complications of reactive arthritis?
Cardiac - aortic reguritation, amyloidosis etc.
