Non autoimmune Arthritis
Definition
Gout: Uric acid mediated inflammation
Pseudogout: Calcium pyrophosphate mediated inflammation
Risk
Thiazide diuretics/ Frusemide
Clinical Features
Gout
Symptoms
DDx
Investigations
Bloods:
Treatment
Gout
Source
Dr Alasdair MacDonald 2014
Gout: Uric acid mediated inflammation
Pseudogout: Calcium pyrophosphate mediated inflammation
Risk
Thiazide diuretics/ Frusemide
Clinical Features
Gout
Symptoms
- Pain
- Mono-arthritis
- Swollen, erythematous joint
- Tophi (hands, feet, ear)
DDx
- Pseudogout
- Monoarticular arthritis (non specific)
- ***Septic arthritis
- Trauma (ACL rupture - aspirate blood)
Investigations
Bloods:
- FBC (septic arthritis), UEC, CMP, Uric acid (not diagnostic), ESR, CRP, RF, ANF
- X ray
- Aspiration (diagnostic - presence of needle like crystals, also culture for sepsis). gout = negative birefringent, pseudogout = positively birefringent
Treatment
Gout
- Acute: NSAIDs/ Colchicine
- Chronic: Allopurinol but only after 4w from last episode
- No evidence that exercise helps
Source
Dr Alasdair MacDonald 2014