630 results
Pseudogout: pathogenesis and clinical findings
 - Idiopathic (vast majority of cases) -> Mechanism unknown
 - Familial
ANKH gene, Incr pyrophosphate ... crystals from joints ... activity, reduces pyrophosphate ... warm, swollen joint ... sclerosis & cysts, joint
Chondrocalcinosis: Calcium Pyrophosphate Dihydrate (CPPD) Deposition Disease

 - Acute CPPD precipitation into the joint space ->
Chondrocalcinosis: Calcium Pyrophosphate ... precipitation into the joint ... precipitation into joint ... selected MCP/PIP joints ... exuberant, often in joints
Joint Disorders - Differential Diagnosis Algorithm
Monoarthritis
 • Septic
 • Crystalline
     - Gout
Joint Disorders ... Pseudogout” - Calcium Pyrophosphate ... Lumbar Spine and SI Joints ... @AmyChung #Joint
Approach to Joint Pain

History:
Is the pain from:
	• Joint
	• Adjacent bursa
	• Tendon
	• Ligament
	• Bone
	• Muscle
	• Referred from
Approach to Joint ... pain from: • Joint ... root Symptoms of Joint ... categories of joint ... urate • Calcium pyrophosphate
Low Alkaline Phosphatase - Hypophosphatasia 

Is Low Alkaline Phosphatase Of Clinical Importance?

ALP enzyme- Discovered in 1923
Low
prematurely • risk of joint ... • Inorganic pyrophosphate ... PPi (inorganic pyrophosphate ... - Pain (muscle/joint
Pseudogout Summary - Calcium Pyrophosphate Deposition Disease (CPPD)

Pathophysiology:
Pyrophosphate produced by chondrocytes likely precipitates with calcium to
Summary - Calcium Pyrophosphate ... Pathophysiology: Pyrophosphate ... swelling in weird joints ... metacarpophalangeal joints ... MCP or shoulder joints
CPPD vs Gout

== CPPD == 

Think About CPPD When:
 • Self-limited synovitis after surgery/trauma (> 65
swelling in weird joints ... Pathophysiology: • Pyrophosphate ... MCP, or shoulder joints ... deposition in joints ... attacks • Other joints
Rheumatology Workup - Laboratories Studies in Rheumatic Diseases

• Septic arthritis - Gram stain and culture of
gout) or calcium pyrophosphate ... spondylitis - Sacroiliac joint ... of the affected joint ... • Sacroiliac joint
Approach to Joint Pain - Diagnostic Framework

1) Chronicity
2) Inflammatory vs Non-Inflammatory
3) Number of Joints Involved

1) Chronicity:
Approach to Joint ... 3) Number of Joints ... weight-bearing joints ... Number of Joints ... late prosthetic joint
Rheumatoid arthritis (RA): Pathogenesis and Joint diseases features
 • RA affects 1% of population, women >
Pathogenesis and Joint ... poly-articular joint ... affecting the small joints ... Joint involvement ... space decr joint