21 results
Arthrocentesis - Joint Fluid Analysis

Effusion Characteristics (Color, Clarity, WCC, PMN, Crystals, Bacteria) by Disease Process: 
OA,
Clarity, WCC, PMN, Crystals ... Pseudogout (positively birefringent ... crystals), Gout ... (negatively birefringent ... crystals), TB arthritis
CPPD vs Gout

== CPPD == 

Think About CPPD When:
 • Self-limited synovitis after surgery/trauma (> 65
Acute CPP Crystal ... Weakly positively birefringent ... or not birefringent ... Needle-shaped, negatively birefringent ... Intracellular (leukocyte
Approach to Gout
Diagnosis: r/o septic arthritis! Needle-shaped, negative birefringent crystals
Treatment:
 • Weight loss, diet, d/c culprit
Approach to Gout ... Needle-shaped, negative birefringent ... crystals Treatment ... flares/year 2) Gouty ... NUIM_Chiefs #gout
Monoarthritis - Differential Diagnosis
Infection (Acute):
 - S. aureus (most common)
 - S. pneumonia
 - Salmonella (in
Coccidioidomycosis Crystal ... - Gout- usually ... early in dz, neg birefringent ... /l wrists, pos birefringent
Gout: Pathogenesis and Clinical Findings
 - Conditions of rapid cell turnover: hemolysis, psoriasis, lymphoproliferative disorders
 -
Gout: Pathogenesis ... cascade results in leukocyte ... phagocytose the crystal ... Needle-shaped uric acid crystals ... Complications #Gout
Atlas of Urine Microscopy Findings
 • Epithelial cells - Normal
 • Renal tubular cells - Acute
Atlas of Urine Microscopy ... fresh at time of microscopy ... glomerular disease • Leukocytes ... tubular injury • Crystals ... - Some crystals
Milk of Urate Bulla - A new blister overlying the radial aspect of the second interphalangeal
polarized light microscopy ... of negatively birefringent ... crystals consistent ... Clinical #Pathology #Gout ... #Microscopy #NEJM
Gout - Diagnosis and Management Summary

3 Conditions for Gout to Manifest:
1. Hyperuricemia
2. Monosodium urate deposition in
to phagocytosed crystals ... Needle-shaped, negatively birefringent ... Intracellular (leukocyte ... ) crystals • Intercritical ... crystals • Gram
Urine Microscopy - Urinary Sediment Examination Instructions
Preparation of the urine for microscopic examination:
 • Clean catch
Urine Microscopy ... protein, blood or leukocyte ... Ill stain) and crystals ... RBC's, lipids, crystals ... identification of lipids, crystals
Pseudogout: pathogenesis and clinical findings
 - Idiopathic (vast majority of cases) -> Mechanism unknown
 - Familial
produced, incr gut ... dihydrate (CPPD) crystals ... x-ray - CPPD Crystals ... - Positively birefringent ... (crystals appear