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Crystal Arthropathies

Kelly Alberda, MD Reviewed 06/2018
 


BASICS

DESCRIPTION

  • Precipitation of crystals in the synovium or synovial fluid causing acute or chronic symptoms in the articular space or adjoining tissues

  • Most common is monosodium urate (MU) crystals...

DIAGNOSIS

HISTORY

  • Usually rapid onset, hours to days, for gout or CPPD. Apatite and oxalate can be more insidious.

  • Gout typically monoarticular and peripheral (first MTP)

  • CPPD can be both monoarticular a...

TREATMENT

GENERAL MEASURES

  • Once the diagnosis of crystal arthropathy is made, initiate treatment without delay.

  • Application of ice or heat is generally not helpful and can cause further crystal precipit...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • Gout: as indicated to control hyperuricemia

    • Monitor uric acid level within 6 weeks of diagnosis.

  • CPPD: Unlike MU crystals, CPPD crystal deposition is irreversible; ...

REFERENCES

1
Khanna PP, Gladue HS, Singh MK, et al. Treatment of acute gout: a systematic review. Semin Arthritis Rheum.  2014;44(1):31–38. {L-End} [View Abstract on OvidMedline]
2
Abhishek A, Dohe...

SEE ALSO

Gout; Pseudogout (Calcium Pyrophosphate Dihydrate) 

CODES

ICD10

  • M11.9 Crystal arthropathy, unspecified

  • M11.20 Other chondrocalcinosis, unspecified site

  • M11.879 Other specified crystal arthropathies, unspecified ankle and foot

  • M1A.9XX0 Chronic gout, unspeci...

CLINICAL PEARLS

  • Gout is more commonly monoarticular, particularly affecting the MTP joint.

  • CPPD can be monoarticular or polyarticular; knee involvement is more common with CPPD.

  • Apatite and calcium oxal...

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