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Crystal Arthropathies

Allison Holley, MD Reviewed 05/2023
 


BASICS

DESCRIPTION

  • Accumulation of precipitated crystals in and around joint spaces causing acute or chronic symptoms.

  • Monosodium urate crystals (gout) most common; others include calcium pyrophosphate ...

DIAGNOSIS

HISTORY

  • Pain, redness, warmth, and swelling of affected joints.

  • Joint Distribution

    • Gout: monoarticular and peripheral (often involves 1st MTP, but not exclusive to this joint)

    • CPPD: may be both ...

TREATMENT

GENERAL MEASURES

  • Once the diagnosis is made, initiate treatment promptly.

  • Application of ice or heat is generally not helpful and may cause further crystal precipitation.

  • Adequate hydration to ...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • Gout: uric-acid lowering agents as indicated to control hyperuricemia in patient with multiple attacks per year.

    • Monitor uric acid level within 6 weeks of diagnosi...

REFERENCES

1
Qaseem  A, Harris  RP, Forciea  MA; for Clinical Guidelines Committee of the American College of Physicians. Management of acute and recurrent gout: a clinical prac...

ADDITIONAL READING

Anderson IJ, Davis AM, Reem H, et al. Management of gout. JAMA. 2021;326(24):2519–2520. doi:10.1001/jama.2021.19763  

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

  • Hydroxyapatite and calci...

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