CC January 2015 Pseudogout

echoecho's version from 2015-05-20 22:41


Question Answer
Define CPPD?Calcium pyrophosphate dihydrate deposition disease is an arthropathy characterized by the accumulation of CPPD crystals in articular tissues
Acute attacks were first termed "pseudogout" to differentiate them from what?acute gout (wehre causative crystals are monosodium urate)
CPPD arthropathy is primary a geriatric disease, affecting an estimated 10-15% of patients ____ to ___ of age and 30-50% of patients > ____ years of age?10-15%; 30-50%
The majority of patients are ______ (symptomatic vs. asymptomatic)?asymptomatic
What is the etiology?unknown
Since the majority of affected patients have underlying damage to their articular cartliage from age or OA, what type of reaction is possible?inflamed cartilage
List the s/s?acute attacks, worsening of specific types of OA, production of symmetrical synovitis that be clinically similar to RA, calcification of spinal ligaments clinically similar to ankylosing spondylitis, spinal stenosis and tophus formation (uncommon)
What is the relationship between CPPD deposition disease and RA?inverse relationship
What is the most commonly affected joint?the knee
List other potential sites?wrist, choulder, ankle, elbow and small joints of the hand
What are the radiographic findings suggestive of CPPD?punctuate and or linear radiodense depositis in fibrocartilaginous joint menisci or articular hyaline cartilage
A definitive dx requires what?presence of weakly positive birefringent rhomboid or rod-like crystals in synovial fluid
Acute attacks are often precipitated by?trauma or rapid reduction in serum calcium levels, as seen following surgical removal of parathyroid glands.
What is the most common s/s with these monoarticular attacks?fever
What lab test is required to differentiate pseudogout from septic arthritis?synovial fluid analysis with cultures
What is commonly found in synovial fluid in pseudogout attacks?leukocytosis
What is the mainstay of acute treatment?joint aspiration with scheduled NSAIDS and /or intra-articular corticosteroid injection
Complete return to baseline function may take up to ____ days?10
Pts who suffer from frequent recurrent pseudogout attacks may benefit from what?low-dose colchicine therapy (though there is no specific rx to remove CPPD deposits from cartilage or synovium)
Rarely large-scale joint destruction is seen necessitating joint replacement, true or false?true
***Which diuretic has been linked with recurrent CPPD, loop or thiazide?loop
Are thiazide use, obesity and alcohol abuse seen as risk fx for CPPD?no