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Flashcards in Crystal arthropathies Deck (18):
1

What is gout?

A crystal arthropathy caused by deposition of uric acid crystals within a joint

2

What is uric acid?

The final breakdown compound of purines in DNA metabolism

3

What are some of the causes of hyperuricaemia?

Underexcretion - exacerbated by diuretics or renal failure
Ingestion of too much alcohol, sea food and red meat

4

What might trigger the formation of uric acid crystals in joints?

Dehydration
Surgery
Trauma
Chemotherapy agents

5

Which sights are most commonly affected by gout?

First metatarsal (big toe, known as Podagra)
Knee
Ankle

6

How does gout present?

Hot, red, swollen joint
Unilateral

7

What other pathology can gout be similar to?

Septic arthritis

8

What are gouty tophi?

Painless white collections of uric acid which can occur in the soft tissues and erupt through the skin

9

What can chronic gout result in?

Destructive erosive arthritis

10

How can gout be diagnosed?

Aspiration of fluid in joint
Synovial fluid examined under polarised microscopy to view uric acid crystals
C&S of fluid done to rule out infection

11

What do the uric acid crystals of gout look like under polarised microscopy?

Needle shaped
Display negative birefringence (change from yellow to blue when lined across direction of polarisation)

12

What is pseudogout?

A crystal arthropathy caused by calcium phosphate crystals collecting in joints

13

What does chondrocalcinosis mean?

The occurrence of deposition of calcium phosphate crystals in cartilidge and soft tissue in the absence of acute inflammation

14

Which joints tend to be affected by pseudogout?

Knee
Wrist
Ankle

15

What conditions can pseudogout co-exist with?

Hyperparathyroidism
Hypothyroidism
Renal osteodystrophy
Haemachromotosis
Wilson's disease

16

What is the treatment for acute attacks of gout?

NSAIDs
Opioid analgesics
Colchicine for those who can't tolerate NSAIDs
Corticosteroids

17

What treatment can be given in between recurrent attacks of gout?

Allopurinol

18

What is the treatment for acute attacks of pseudogout?

NSAIDs
Corticosteroids (systemic and intra-articular)