Crystal Induced Arthropathy

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Gout BUT ‐ Eighty percent of people with uric acid over 7 mg/dl do not develop gout. Risk of gout related to level of uric acid in 2046 men followed for 14.9 years UA level 5 year incidence of gout * 7 –7.9 2% 8 –8.9 4.1% 9 – 9.9 29.8% > 10 30.5% Hyperuricemia appears to lead to similar risk of gout in women as in men Amer J Med 1987;82:421-26
Gout ‐ Diagnosis Typically acute monoarthritis Serum uric acid may be misleading – Normal in up to 40% at time of attack Frequently elevated without symptoms or with musculoskeletal symptoms unrelated to gout Best diagnostic clues Sensitivity Specificity* Podagra 96 97 Tophi 30 99 Urate crystals in Synovial fluid 84 100 Arthrocentesis ‐ best way to confirm Negatively birefringent crystals YUPA ‐ yellow urate parallel axis *Adapted from Am Fam Phy 2007;2007:801
Page 1 and 2: Update on Crystal Related Arthritis
Page 3: Gout A disorder related to monosod
Page 7 and 8: Compensated polarized microscopy -
Page 9: Gout in the Older Patient Incidenc
Page 14 and 15: Gout & Related Conditions Hyperten
Page 16 and 17: Hyperuricemia - A Cause of or Marke
Page 18 and 19: So What Should We Do? Should we tr
Page 20 and 21: Gout - Treatment of Acute Attack C
Page 22 and 23: Gout ‐ Treatment Acute Attack AC
Page 24 and 25: Allopurinol Dose - Initial ‐ 10
Page 26 and 27: Allopurinol Hypersensitivity Syndro
Page 28 and 29: Febuxostat Approved in U.S. for 40
Page 30 and 31: Other Ways to Reduce Risk of Gout
Page 32 and 33: Treatments on the Horizon Acute at
Page 34 and 35: Calcium Pyrophosphate Dihydrate Dep
Page 36 and 37: Clincal Clues to Diagnosis Pseudog
Page 38 and 39: CPPD ‐ Diagnosis Other suggestiv
Page 40 and 41: From the ACR slide collection ©
Page 42: CPPD ‐ Treatment Psuedogout Asp

Crystal Induced Arthropathy

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