At what age can you get Calcium Pyrophosphate Dyhidrate Deposition Disease (CPPD)?
- onset after 30yrs
Peak incidence: at 60yrs
What are some other diseases that CPPD can simulate?
- Charcot's joint
What joints are predominantly affected in CPPD?
What would a positive lab test for CPPD show?
CPPD crystals on aspiration
List some possible DDx for CPPD?
W - ilsons disease
H - yperthyroidism
I - diopathic
P - seudo-gout
A - cromagaly, Amyloidosis
D - iapetes
O - chranosis
G - out
What is the age/gender predelection of Hydroxyapetite Deposition Disease (HADD)?
What are some clinical features of HADD?
- joint pain
What joints does HADD affect?
- m.c = Shoulder (supraspinatus tendon) rotator cuff
- Also hips and Cervical Spine
What occurs at the site of crystal deposition (HADD)?
What is the Etiology of HADD?
- Etiology unknown
- Possibly: Genetic, age, biomechanics, trauma
What is Gout?
"rich mans disease" It occurs due to a purine metabolism disorder, in which purine produced >excreted
uric acid thus deposits as Tophus
What body region does Gout affect?
- m.c involves feet
- primarily periarticular
What is the age/gender/demographic predelection to Gout?
>40yrs at time of onset.
Demographic: post menopause patients on diuretics
Family history common
What clinical features are evident during the initial onset of Gout?
And what happens if it becomes chronic?
Initial onset: Can be asymptomatic, but usually very acute and painful.
Chronic: becomes polyarticular
What are the clinical features of Gout during the Acute Phase (First phase)?
- Attack usually early morning
- 60% at 1st MTP joint
- Swollen, hot but dry, rapid recovery in days
- Many pts. are asymptomatic for years
What are the clinical features of Gout during the Polyarticular Phase (second phase)?
- Multiple attacks increase chance of >1 joint involvement
- This stage is where radiographic changes are first seen
What are the clinical features of Gout during the Chronic Tophaceous Phase (third phase)?