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Crystal Arthropathies

Melissa Palma, MD and Rowland Chang, MD, MPH Reviewed 06/2019
 


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 d...

DIAGNOSIS

HISTORY

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

  • Usually rapid onset, hours to days, for gout or CPPD; apatite and oxalate may be more insidious.

  • Difficulty bearing weight; painfu...

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 diagnos...

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 practice guideline from the Ame...

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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