9- PSEUDOGOUT

• Shedding of crystals


  Acute synovitis
• Patients


  • Mostly elderly women
  • Usually in large joints (knee or wrist)
• Risk factors (especially if in the young)


  • Hyperparathyroidism
  • Hemochromatosis
  • Wilson's disease
  • Alkaptonuria
  • Diabetes
• Joint fluid microscopy


  • Positively birefringent small brick-shape pyrophosphate
• 1. ray


  • Chondrocalcinosis (linear calcification parallel to joint surface)
• CBC


  • High WBC
• Treatment


  1. NSAIDs

  2. If severe/nonresponsive: intraarticular steroids

  3. Low dose colchicine as prophylaxis between attacks