Five patients had abnormal thyroid hormone levels, but only one presented with clinical hypothyroidism. Four patients showed increased parathormone levels, but only one presented with clinical hyperparathyroidism. [ncbi.nlm.nih.gov]

G6PD Risk factors for pseudogout Association with trauma and osteoarthritis Hyperparathyroidism Wilson’s disease Haemochromatosis Loop diuretics causing hypomagnasaemia Presentation of gout (presents in four ways): Acute urate synovitis (acute attack [oxfordmedicaleducation.com]

This presentation is not well understood and does not have good treatment alternatives. [mdedge.com]

• Hunting

  The Journal of Bone & Joint Surgery Case Connector 2(4):e59-1. doi: 1 0.2106/JBJS.CC.K.00167 30 Hunte TC, Bernstein HM, Dickinson GM. Acute Crystalline Arthritis in an Artificial Knee. [ghrnet.org]

  Schumacher HR Jr, Becker MA, Wortmann RL, Macdonald PA, Hunt B, Streit J, et al. [emedicine.medscape.com]

• Soft Tissue Mass

  Crystal arthropathies are a group of joint disorders due to deposition of crystals in and around joints which lead to joint destruction and soft tissue masses. [radiopaedia.org]

• Localized Edema

  Calcium pyrophosphate deposition disease should be on the differential diagnosis in the elderly patient presenting with a clinical picture that resembles “seronegative” RA, with morning stiffness, synovial thickening, localized edema, and restricted motion [mdedge.com]

• Arthritis

  The disease course was characterised by acute episodic arthritis in 16 (32%) patients and by persistent symptoms (with or without synovitis) in 34 (68%). [ncbi.nlm.nih.gov]

  Type IIa hyperlipoproteinemia Amyloidosis Multicentric reticulohistiocytosis Hyperparathyroidism Spondyloarthropathy Rheumatoid arthritis Fibromyalgia [en.wikipedia.org]

  Autoimmune arthritis happens when your body's immune system attacks healthy cells in your body by mistake. Rheumatoid arthritis is the most common form of this kind of arthritis. Juvenile arthritis is a type of arthritis that happens in children. [icdlist.com]

• Joint Swelling

  This leads to attacks of joint swelling and pain in the knees, wrists, ankles, and other joints. Among older adults, CPPD is a common cause of sudden (acute) arthritis in one joint. [medlineplus.gov]

  Generic features of joint swelling, localised warmth, pyrexia and painful reduced range of movement were evident in the presentation descriptions of all of the cases we reviewed emphasizing the close resemblance of peri-prosthetic arthropathy with infection [ghrnet.org]

  In general, gout includes joint swelling in both the lower and upper extremities. [clevelandclinicmeded.com]

  The majority of patients with rheumatoid arthritis will test positive for rheumatoid factors and a rheumatoid arthritis diagnosis requires the presence of certain other symptoms: morning stiffness, multiple joint swelling, rheumatoid nodules, and evidence [physio-pedia.com]

  For instance, a 50-year-old woman with symmetric, progressive polyarticular joint swelling and prolonged morning stiffness would seem to have rheumatoid arthritis. [aafp.org]

• Joint Effusion

  Peri-prosthetic infection can present acutely with features including erythema, localized warmth around the joint, effusion, pyrexia and general lethargy. [omicsonline.org]

  In the absence of joint effusion or indications to obtain a synovial biopsy, chondrocalcinosis is presumptive of CPPD deposition. One exception is chondrocalcinosis due to CaOx in some patients with chronic renal failure. [what-when-how.com]

  Spontaneous ruptures of the tibialis anterior, quadriceps, and Achilles tendons have been reported. 5,6 In the acute stage of gout, MRI findings of the joint effusion and synovial thickening are nonspecific. [appliedradiology.com]

  Treatment  The acute attack  Resting the joint  Applying ice packs if pain is severe,  NSAIDs  Colchicine (may cause diarrhoea, nausea and vomiting)  A tense joint effusion may require aspiration and intra-articular injection of corticosteroids. [slideshare.net]

  Musculoskeletal ultrasound of the knee showing joint effusion and hyperechoic signals consistent with CPP-crystal synovial calcifications (longitudinal view of a knee in extension). [rheumatologyadvisor.com]

• Arthralgia

  For example, the acute stage of Lyme disease may include polyarticular arthralgias, whereas the chronic phase may include oligoarthritis, primarily in the knees. 17 SYMMETRY Joint involvement tends to be symmetric in systemic diseases such as rheumatoid [aafp.org]

  The most frequently reported adverse effects are diarrhea, back pain, headaches, and arthralgias. Also, patients should be monitored for thromboembolic events and increased hepatic transaminases. [clevelandclinicmeded.com]

  If the patient later suffers from chronic arthralgias, corticosteroids should be avoided [24]. Steroids are administered when inflammatory symptoms are resistant to NSAIDs [75]. [physio-pedia.com]

• Self-Mutilation

  Kelley Geegmiller Syndrome Lesch Nyhan (complete x-linked, MR and self-mutilation) Kelley Geegmiller (incomplete x-linked, no neurologic/behavioral feature) What percentage of patients with hyperuricemia and gout have a deficient RENAL EXCRETION of gout [cram.com]

Differentiation of crystal arthropathy from septic arthritis is the primary aim of the diagnostic workup process. Cases of simultaneous crystal arthropathy and septic arthritis can also occur however, further complicating the clinical evaluation[6]. [ghrnet.org]

Classic radiographic findings are highly suggestive (see Workup ). [emedicine.medscape.com]

Gout or hyperuricemia in an adolescent or child is rare but invariably a manifestation of an underlying metabolic or inherited enzyme deficiency warranting a workup for these diseases. Postmenopausal women. [clevelandclinicmeded.com]

• Soft Tissue Calcification

  Radiographs may reveal chondrocalcinosis or soft-tissue calcifications. [what-when-how.com]

Treatment of disorders associated with gout or calcium pyrophosphate deposition may reduce non-joint morbidity and assist treatment of the arthritis. [ncbi.nlm.nih.gov]

What to Expect The diagnosis and treatment of gout and crystal arthropathy requires a careful review of a patient’s symptoms, physical findings, and previous testing. [massgeneral.org]

Treat your patients effectively using the latest information on drug treatments, from the recently-approved Uloric to Kristexx and Colcryst, which are still under review. [elsevier.com]

This presentation is not well understood and does not have good treatment alternatives. [mdedge.com]

Prognosis [ 2 ] Acute attacks usually resolve within ten days. [ 9 ] Some patients develop progressive joint damage with functional limitation. Prognosis will also be dependent on any underlying cause. [patient.info]

The prognosis for individual attacks of acute calcium pyrophosphate arthritis is usually excellent. However, chronic arthritis can occur, and severe destructive arthropathy resembling neurogenic arthropathy (Charcot joints) occasionally occurs. [merckmanuals.com]

 Prognosis  1. Acute attacks self-limited, resolve 7-10 days  2. Progressive joint damage; destructive arthropathy resembling neuropathic(Charcot’s) joints  3. Large joint arthropathy may require joint replacement 54. II. [slideshare.net]

Prognosis Gout cannot be cured but usually it can be managed successfully. As tophi dissolve, joint mobility generally improves. (In some cases, however, medicines alone do not dissolve the tophi and they must be removed surgically.) [medical-dictionary.thefreedictionary.com]

Prognosis CPPD crystal deposition disease is a chronic (long-lasting) disorder with recurrent flare-ups. This means it may occur periodically throughout your lifetime. Some people have only one or at the most a few attacks in a lifetime. [orthop.washington.edu]

Prevalence Widespread in older population M:F 3:2 Clinical findings Intermittent attacks May be mono-articular or polyarticular (more often) Pain Redness Swelling Types Frequently occurs in association with osteoarthritis Aging process with no known etiology [learningradiology.com]

MRI features associated with crystal deposition diseases include size, soft-tissue signal characteristics, arthritic changes, as well as etiology and common locations of such deposition diseases. [appliedradiology.com]

(See Pathophysiology and Etiology.) Gout is one of the oldest diseases in the medical literature, [1, 2] known since the time of the ancient Greeks. [emedicine.medscape.com]

Hypomagnesemia due to renal disease of unknown etiology. Am J Med. 1975;59(6):873–881. 52. Doherty M, Dieppe PA. Double blind, placebo controlled trial of magnesium carbonate in chronic pyrophosphate arthropathy. Ann Rheum Dis. 1983;42:106–110. [dovepress.com]

The specific cause of virus-induced arthritis is not always investigated; thus, the prevalence of viruses as the etiology of arthritis may be underestimated. 8 Except for Neisseria gonorrhoeae, direct bacterial infections in joints seldom cause polyarthritis [aafp.org]

His research is focused on a number of key elements in OA including (but not limited to) the epidemiology of osteoarthritis, the application of imaging to better understand structure and function with application to both epidemiologic research and clinical [amazon.com]

This article reviews the relevant epidemiologic data, with a focus on recent progress and data on other crystal arthropathies. [ncbi.nlm.nih.gov]

Hunter, Hans Bijlsma, Nigel Arden, and Nicola Dalbeth Abstract The Oxford Textbook of Osteoarthritis and Crystal Arthropathy provides full coverage of joint failure, and includes detailed sections on epidemiology, risk factors, clinical assessment, and [oxfordmedicine.com]

Menschel: Pathophysiology of peri-articular bone changes in osteoarthritis 6 Floris Lafeber, N.J. Besselink and S.C. Mastbergen: Osteoarthritis: synovium and capsule 7 Jason J. McDougall and Joel A. Vilensky: Neuromuscular 3. [oupjapan.co.jp]

Providing a historical perspective throughout, this work includes detailed descriptions of the clinical features of these diseases, as well as a current overview of their identification, epidemiology, genetics, and underlying pathophysiology. [crcpress.com]

Gout and pseudogout pathophysiology Gout and pseudogout are crystal arthropathies Crystals of urate (in gout) and calcium pyrophosphate (in pseudogout) are precipitated in joints Neutrophils phagocytose the crystals whilst releasing pro-inflammatory cytokines [oxfordmedicaleducation.com]

Definition / general Also called pseudogout, chondrocalcinosis Common finding in arthritic joints Pathophysiology Calcium pyrophosphate dehydrate (CPPD) crystals develop first in menisci and intervertebral discs, may seed the joint and elicit neutrophilic [pathologyoutlines.com]

Identifying and characterizing modifiable risk factors for gout is a major step in preventing and managing this painful condition. [ncbi.nlm.nih.gov]

[…] the meaning and significance of hyperuricemia (elevated uric acid levels) in relation to crystal formation, and the clinical manifestations of gout, as well as the importance of treating-to-target when using uric acid-lowering therapy and the need for preventing [massgeneral.org]

Rapidly find the answers you need with separate sections on diseases and disorders, differential diagnosis, clinical algorithms, laboratory results, and clinical preventive services, plus an at-a-glance format that uses cross-references, outlines, bullets [books.google.com]

Gout can be prevented by the use of allopurinol which lowers the levels of uric acid in the blood. [medical-dictionary.thefreedictionary.com]