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Joint Disorders - Differential Diagnosis Algorithm Monoarthritis • Septic • Crystalline - Gout
Crystals - “Pseudogout ... Amy Chung, MD, MSc ... Joint #Disorders #msk
Approach to Joint Pain - Diagnostic Framework 1) Chronicity 2) Inflammatory vs Non-Inflammatory 3) Number of Joints Involved 1) Chronicity:
arthritis, gout or pseudogout ... Spondyloarthropathies, gout, pseudogout ... Rhomboid, blue = pseudogout ... #Joint #Pain #MSK
Inflammatory Joint Pain - Differential Diagnosis Algorithm Monoarticular • Gout (Podagra, Tophi) • Pseudogout • Early
Podagra, Tophi) • Pseudogout ... Inflammatory #JointPain #MSK
Approach to Joint Pain - Arthritis Differential Diagnosis Framework Inflammatory Versus Noninflammatory Pain • Is it inflammatory
induced (Gout/Pseudogout ... Lyme • Gout/Pseudogout ... Differential #Diagnosis #MSK
Leg Pain - Differential Diagnosis Framework Bone/Joint Causes of Leg Pain: • Fracture • Arthritis • Gout/pseudogout
Arthritis • Gout/pseudogout ... lower #extremity #msk
Arthrocentesis - Joint Fluid Analysis Effusion Characteristics (Color, Clarity, WCC, PMN, Crystals, Bacteria) by Disease Process: OA,
arthritis SLE, , RF , Pseudogout ... Table #Aspiration #Pseudogout
Synovial Fluid Analysis: Findings (COLOR TRANSPARENCY VISCOSITY WBC COUNT (PER MM3) PMN CELL COUNT (%) GRAM STAIN CULTURE PCR TEST CRYSTALS) By Condition (Normal Noninflammatory Inflammatory:
Table #Aspiration #Pseudogout
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 Arthrocentesis of synovial fluid - Interpretation - Normal - Noninflammatory - Inflammatory - Septic Viscosity of synovial
Table #Aspiration #Pseudogout
Knee Effusions - Arthrocentesis Interpretation Inflammatory arthritis: • Color: Yellow-> Green • Clarity: Opaque • Viscosity: Low
analysis: • MSU ... Gout • CPPD: Pseudogout
Pseudogout: pathogenesis and clinical findings - Idiopathic (vast majority of cases) -> Mechanism unknown - Familial
Pseudogout: pathogenesis ... Chondrocalcinosis #Pseudogout
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