Crystal Arthropathies Flashcards
state the most common crystal arthropathy
gout
what crystals are deposited in the joint in those with gout?
urate
urate crystals are due to high levels of what?
serum uric acid levels (hyperuricaemia)
uric acid is the final compound in the breakdown of purines in DNA metabolism - name the 2 purines
adenine and guanine
name the 2 causes of hyperuricaemia
underexretion or excessive intake:
renal failure or diuretics or due to excessive alcohol, red meat and sea food intake
what can uric acid be triggered by?
dehydration
trauma
surgery
name the most common joint affected by gout
first metatarsalphalangeal (MTP) joint - podagra
ankle and knee also
clinical signs and symptoms of gout?
intensely painful red, hot swollen joint which may mimic a septic arthritis
how long do symptoms last in gout?
7-10 days if untreated then resolve
name the painless white accumulations of uric acid which can occur in the soft tissues and occasionally erupt through the skin
gouty tophi
what can chronic gout result in?
destructive erosive arthritis
name the test performed to make a definitive diagnosis of gout
polarised microscopy
what do uric acid crystals look like under polarised microscopy?
needle shaped
strong (negative) birefringence - yellow to blue
acute gout treatment?
NSAIDs
corticosteroids
opioid analgesics
recurrent attack gout treatment?
rate lowering therapy - allopurinol
only start after the acute phase has died or eye it exacerbates it