705 results match your criteria Gout and Pseudogout


Septic and Crystal-Induced Arthritis (Pseudogout) Post-COVID-19 Vaccination.

Cureus 2022 Apr 6;14(4):e23902. Epub 2022 Apr 6.

Infectious Disease, Howard University Hospital, Washington, DC, USA.

Severe acute respiratory syndrome coronavirus 2 infection has been a global public health crisis for the past two years. Vaccination has been a mainstay preventive approach among other strategies such as hand washing, social distancing, and wearing facemasks. Here, we present a case of concomitant calcium pyrophosphate deposition disease flare and septic arthritis of the right knee following coronavirus disease 2019 (COVID-19) booster vaccination in a 69-year-old African American male who presented with a painful swollen right knee with associated fever, chills, and rigors three days post-vaccination. Read More

View Article and Full-Text PDF

Risk factors for septic arthritis and multiple arthroscopic washouts: minimum 2-year follow-up at a major trauma centre.

Clin Rheumatol 2022 Apr 2. Epub 2022 Apr 2.

Department of Trauma and Orthopaedics, Addenbrooke's Hospital, Cambridge, CB2 0QQ, UK.

Background: Septic arthritis (SA) is a dangerous condition that requires emergency treatment. Managed by culture-specific antibiotics, irrigation, and debridement (I&D), some patients require repeat surgical treatment. The objectives were to determine the risk factors for SA and risk factors for repeat arthroscopic I&D in SA patients. Read More

View Article and Full-Text PDF

Knee Arthrocentesis in Adults.

J Vis Exp 2022 02 25(180). Epub 2022 Feb 25.

Department of Medicine, BronxCare Health System.

Arthrocentesis of the knee is a procedure in which a needle is inserted into the knee joint, and synovial fluid is aspirated. An arthrocentesis can be diagnostic or therapeutic. Synovial fluid may be removed for testing to determine the nature of the knee effusion. Read More

View Article and Full-Text PDF
February 2022

Acute Calcium Pyrophosphate Crystal Arthritis of the Wrist Elicited by Anti-COVID-19 Vaccination After Carpal Tunnel Release.

Am J Case Rep 2022 Mar 12;23:e934833. Epub 2022 Mar 12.

Plastic and Reconstructive Surgery Unit, Padua University Hospital, Padua, Italy.

BACKGROUND Calcium pyrophosphate dihydrate deposition disease includes a variety of clinical syndromes, including acute calcium pyrophosphate (CPP) crystal arthritis. Most patients with CPP crystal arthritis have a primary/idiopathic form presenting with severe pain, swelling, and stiffness. COVID-19 infection, which originated in China in December 2019, required extraordinary efforts to develop and test new vaccines to halt the pandemic. Read More

View Article and Full-Text PDF

Gout in Primary Hyperparathyroidism, Connecting Crystals to the Minerals.

J Endocr Soc 2022 Apr 9;6(4):bvac018. Epub 2022 Feb 9.

Department of Pathology, AIIMS, Jodhpur, Rajasthan, 342005, India.

Musculoskeletal manifestations in primary hyperparathyroidism (PHPT) range from 13% to 93% encompassing pseudogout, vertebral fracture, myopathy, and cord compression. Though pseudogout has been the most prevalent musculoskeletal condition in PHPT, rarely reports of acute gouty attacks in large joints including the knee have been reported in the literature. Here we detail a unique case of PHPT presenting with acute severe bilateral knee joint inflammatory arthritis accompanied by occasional abdominal pain. Read More

View Article and Full-Text PDF

Green Pixels on DECT: Is it Gout?

Am J Med Sci 2022 Feb 10. Epub 2022 Feb 10.

Department of Medicine, Division of Rheumatology, Mayo Clinic Hospital, Phoenix, AZ, USA.

View Article and Full-Text PDF
February 2022

Screening of Fv Antibodies with Specific Binding Activities to Monosodium Urate and Calcium Pyrophosphate Dihydrate Crystals for the Diagnosis of Gout and Pseudogout.

ACS Appl Bio Mater 2021 04 6;4(4):3388-3397. Epub 2021 Apr 6.

Department of Materials Science and Engineering, Yonsei University, 50 Yonsei-Ro, Seodaemun-gu, Seoul 03722, Korea.

To date, medical diagnosis of gout and pseudogout has been performed by observing the crystals in the joint fluid of patients under a polarized microscope. Conventional diagnostic methods using a polarized microscope have disadvantages, such as time-consuming analysis, a high false negative rate, and difficulty in distinguishing gout with monosodium urate (MSU) crystals and pseudogout with calcium pyrophosphate dihydrate (CPPD) crystals in synovial fluids. In this study, a chromogenic assay for the diagnosis of gout and pseudogout, without the requirement of a polarized microscope and trained experts, was proposed using Fv antibodies with specific binding activities to MSU and CPPD crystals. Read More

View Article and Full-Text PDF

[Management of joint empyema].

Unfallchirurg 2022 Jan 7;125(1):19-25. Epub 2021 Dec 7.

Klinik für Unfallchirurgie, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland.

Joint empyema, also known as septic arthritis, is a severe disease associated with considerable morbidity and mortality. Failing to initiate immediate treatment can result in irreversible joint destruction within a short time. The knee joint is most frequently involved, followed by the shoulder and hip joints. Read More

View Article and Full-Text PDF
January 2022

Calcium pyrophosphate deposition (CPPD) disease - Treatment options.

Best Pract Res Clin Rheumatol 2021 12 28;35(4):101720. Epub 2021 Oct 28.

Mater Misericordiae University Hospital, Eccles St, Dublin 7, Ireland; University College Dublin, Ireland. Electronic address:

In contrast to gout, no disease-modifying therapies currently exist that reduce articular crystal deposition of calcium pyrophosphate crystals (CPPs). Treatment is aimed at ameliorating the inflammatory response and reducing the frequency and severity of clinical symptoms due to CPP deposition (CPPD). Despite being one of the most common forms of inflammatory arthritis, CPPD remains under-studied and evidence-based treatment guidelines remain lacking. Read More

View Article and Full-Text PDF
December 2021

One Joint Aspirate: Three Diagnoses.

Cureus 2021 Sep 4;13(9):e17714. Epub 2021 Sep 4.

Internal Medicine, University of New Mexico School of Medicine, Albuquerque, USA.

Gout is a frequently diagnosed condition. However, it is rarely diagnosed with concomitant pseudogout or reactive arthritis (ReA) from ​​​​​. This case report describes an interesting case of a 67-year-old man who presented with a two-week history of malaise, chills, and shortness of breath. Read More

View Article and Full-Text PDF
September 2021

Crowned dens syndrome: a key differential for acute neck pain in the elderly.

N Z Med J 2021 09 3;134(1541):130-133. Epub 2021 Sep 3.

Consultant Physician and Rheumatologist, Whangarei Hospital, New Zealand.

View Article and Full-Text PDF
September 2021

Regulation of crystal induced inflammation: current understandings and clinical implications.

Expert Rev Clin Immunol 2021 07 18;17(7):773-787. Epub 2021 Jun 18.

Rheumatology Unit, Department of Medicine - DIMED, University of Padova, Padova, Italy.

: Accumulation of abnormal crystals in the body, derived from endogenous or exogenous materials can drive a wide spectrum of inflammatory disease states. It is well established that intra-articular deposition of monosodium urate (MSU) and calcium pyrophoshate (CPP) crystals contributes to joint destruction through pro-inflammatory processes.: This review will focus on current understanding and recent novelty about the mechanisms and the clinical implications of the inflammation induced by MSU and CPP crystals. Read More

View Article and Full-Text PDF

Burden of atrial fibrillation in patients with rheumatic diseases.

World J Clin Cases 2021 May;9(14):3252-3264

Department of Cardiology, St. Mary Medical Center, Langhorne, PA 19047, United States.

Background: Studies have suggested that atrial fibrillation (AF) in patients with rheumatic diseases (RD) may be due to inflammation.

Aim: To determine the highest association of AF among hospitalized RD patients and to determine morbidity and mortality associated with AF in hospitalized patients with RD.

Methods: The National inpatient sample database from October 2015 to December 2017 was analyzed to identify hospitalized patients with RD with and without AF. Read More

View Article and Full-Text PDF

Approach to a patient with monoarticular disease.

Autoimmun Rev 2021 Jul 7;20(7):102848. Epub 2021 May 7.

Rheumatology Unit, Bnai-Zion Medical Center and Technion, Haifa, Israel; Ruth & Bruce Rappaport Faculty of Medicine, Technion, Haifa, Israel. Electronic address:

Purpose: To reassess the diagnostic approach to a patient with a monoarticular disease in light of the up-to-date medical literature and to examine the practical utility of traditional and newer imaging tools in the setting of monoarthritis.

Results: The monoarticular disease can represent a medical emergency on the one hand and be a diagnostic conundrum on the other. The management rules of patients with monoarthritis have been established long ago, but various pitfalls still lead physicians off the right diagnosis at times. Read More

View Article and Full-Text PDF

20 Years of Radiographic Imaging: Crystalline Deposits Causing Severe Arthropathy and Erosions.

Mil Med 2021 Apr 7. Epub 2021 Apr 7.

Department of Rheumatology, Tripler Army Medical Center, Honolulu, HI 96859, USA.

Urate crystal gout arthritis and calcium pyrophosphate deposition disease (CPPD) are crystalline arthropathies seen in middle age to elderly patients, but are also seen in the active duty military population. Flares of either can be identified by acute joint pain, associated swelling, tenderness, and warmth. Definitive diagnosis involves synovial analysis from arthrocentesis. Read More

View Article and Full-Text PDF

Simultaneous Homozygous Mutations in and in an Inbred Chinese Pedigree.

Genes (Basel) 2021 03 5;12(3). Epub 2021 Mar 5.

Department of Nephrology, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Long-quan Branch, Longquan 323716, China.

Gitelman syndrome (GS) and Bartter syndrome (BS) type III are both rare, recessively inherited salt-losing tubulopathies caused by and mutations, respectively. We described a 48-year-old male patient with fatigue, carpopedal spasm, arthralgia, hypokalemic alkalosis, mild renal dysfunction, hypomagnesemia, hypocalciuria, hyperuricemia, normotension, hyperreninemia and chondrocalcinosis in knees and Achilles tendons. His parents are first cousin. Read More

View Article and Full-Text PDF

Highly specific and label-free histological identification of microcrystals in fresh human gout tissues with stimulated Raman scattering.

Theranostics 2021 1;11(7):3074-3088. Epub 2021 Jan 1.

State Key Laboratory of Surface Physics and Department of Physics, Human Phenome Institute, Multiscale Research Institute of Complex Systems, Academy for Engineering and Technology, Key Laboratory of Micro and Nano Photonic Structures (Ministry of Education), Fudan University, Shanghai 200433, China.

Gout is a common metabolic disease with growing burden, caused by monosodium urate (MSU) microcrystal deposition. In situ and chemical-specific histological identification of MSU is crucial in the diagnosis and management of gout, yet it remains inaccessible for current histological methods. Stimulated Raman scattering (SRS) microscopy was utilized to image MSU based on its fingerprint Raman spectra. Read More

View Article and Full-Text PDF

Neutrophil extracellular traps release in gout and pseudogout depends on the number of crystals regardless of leukocyte count.

Rheumatology (Oxford) 2021 10;60(10):4920-4928

Rheumatology Unit, Department of Medical Sciences, Surgery and Neurosciences, Policlinico Santa Maria alle Scotte.

Objectives: Microcrystal-induced arthritis is still an unresolved paradigm for medicine. Overt inflammation may be absent even when crystals occur in SF. Recently, the production of neutrophil extracellular traps (NETs) embedding MSU crystals has been proposed as a possible mechanism of the auto-resolution of the inflammatory phase during gout. Read More

View Article and Full-Text PDF
October 2021

Calcium Pyrophosphate Dihydrate Crystals Increase the Granulocyte/Monocyte Progenitor (GMP) and Enhance Granulocyte and Monocyte Differentiation In Vivo.

Int J Mol Sci 2020 Dec 29;22(1). Epub 2020 Dec 29.

Department of Immunology, Kanazawa Medical University, Ishikawa 920-0293, Japan.

Calcium pyrophosphate dihydrate (CPPD) crystals are formed locally within the joints, leading to pseudogout. Although the mobilization of local granulocytes can be observed in joints where pseudogout has manifested, the mechanism of this activity remains poorly understood. In this study, CPPD crystals were administered to mice, and the dynamics of splenic and peripheral blood myeloid cells were analyzed. Read More

View Article and Full-Text PDF
December 2020

Management of calcium pyrophosphate crystal deposition disease: A systematic review.

Semin Arthritis Rheum 2021 02 21;51(1):84-94. Epub 2020 Dec 21.

Department of Medicine, Division of Rheumatology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.

Objective: Calcium pyrophosphate crystal deposition disease (CPPD) is a common cause of acute and chronic arthritis, especially in the elderly population. There is a paucity of data regarding the management of CPPD disease, which is currently based on expert opinion and evidence derived from the treatment of gout. We conducted a systematic literature review in order to identify the available treatment options for CPPD, and describe their efficacy and safety. Read More

View Article and Full-Text PDF
February 2021

Unilateral knee effusion in an elderly patient: an unusual presentation of rheumatoid arthritis.

J Prim Health Care 2020 12;12(4):391-394

University of Colorado School of Medicine, Department of Family Medicine & Orthopedics, Division of Sports Medicine, AF Williams Clinic, Denver, Colorado, USA.

Unilateral atraumatic knee effusion is a relatively common presenting complaint among geriatric patients in primary care and musculoskeletal speciality clinics. Gout, pseudogout, degenerative joint diseases and reactive arthritis are the most common causes of the atraumatic knee effusions. Rheumatoid arthritis very rarely presents as arthritis of one or two large joints. Read More

View Article and Full-Text PDF
December 2020

Clinical implications of synovial fluid specimen handling for crystal associated arthritides: A systematic review.

Int J Rheum Dis 2021 Jan 5;24(1):10-20. Epub 2020 Nov 5.

Division of Rheumatology, Department of Internal Medicine, Mayo Clinic, Scottsdale, AZ, USA.

Aim: To identify the appropriate methods of synovial fluid (SF) specimen storage, manipulation and handling for crystal associated arthritides (CAA) diagnosis.

Method: A systematic literature review was conducted using 5 medical databases to identify diagnostic studies assessing SF specimen handling for calcium pyrophosphate (CPP) and monosodium urate (MSU) crystals identification. All included studies were rated for quality using the Quality Assessment of Diagnostic Accuracy Studies 2. Read More

View Article and Full-Text PDF
January 2021

Colchicine: An Ancient Drug with Multiple Benefits.

Curr Pharm Des 2021;27(26):2917-2924

Division of Rheumatology, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon.

The history of colchicine dates to ancient Egyptians when it was used for alleviation of swelling and pain. Although its popularity varied throughout the years, colchicine has been a mainstay for the treatment of several diseases, mainly rheumatic and cardiac ones. The mechanism of action of the drug involves several intracellular and extracellular targets, although interaction with tubulin is the most described. Read More

View Article and Full-Text PDF
October 2021

Imaging of crystalline arthropathy in 2020.

Best Pract Res Clin Rheumatol 2020 12 1;34(6):101595. Epub 2020 Oct 1.

Division of Allergy, Immunology and Rheumatology, Department of Medicine, University of Rochester, Rochester, NY, USA. Electronic address:

Crystal-related arthropathies are the result of crystal deposition in joint and periarticular soft tissues. Identification of urate crystals is mandatory to distinguish gout from other crystalline arthropathies, including calcium pyrophosphate dihydrate and basic calcium phosphate crystal deposition diseases. ACR/EULAR classification criteria for gout included dual-energy computed tomography and ultrasound with equal impact to the final score. Read More

View Article and Full-Text PDF
December 2020

Distinguishing Periprosthetic Crystalline Arthropathy from Infection in Total Knee Arthroplasty: A Systematic Review.

J Knee Surg 2020 Sep 17. Epub 2020 Sep 17.

Department of Orthopaedic Surgery, Hospital for Special Surgery, New York City, New York.

Distinguishing periprosthetic crystalline arthropathy from periprosthetic joint infection (PJI) remains a diagnostic challenge as both symptom presentation and diagnostic tests overlap. Accurate differentiation is important as treatment plans vary significantly. We sought to systematically review all cases of total knee arthroplasty (TKA) periprosthetic crystalline arthropathy reported in the literature and summarize clinical, diagnostic, and operative findings in the context of guidelines for diagnosing PJI. Read More

View Article and Full-Text PDF
September 2020

Coexistence of gout and chondrocalcinosis instead? Comment on: "Monosodium urate deposition in the articular cartilage and meniscus can mimic chondrocalcinosis" by Bousson et al. Joint Bone Spine 2020, 87:95-96.

Authors:
Angel Checa

Joint Bone Spine 2020 12 24;87(6):677. Epub 2020 Jul 24.

Pavia Yauco Hospital School of Medicine, Yauco Puerto Rico, Former Research Faculty at the Division of Rheumatology Drexel University College of Medicine, United States. Electronic address:

View Article and Full-Text PDF
December 2020

Calcium Pyrophosphate Dihydrate Crystal Deposition in Gouty Tophi.

Arthritis Rheumatol 2021 02 5;73(2):324-329. Epub 2020 Dec 5.

Université de Paris, INSERM UMR 1132, Hôpital Lariboisière, AP-HP, Paris, France, and Vien Gut Medical Center and French-Vietnamese research center on gout and chronic diseases, Ho Chi Minh City, Vietnam.

Objective: The coexistence of calcium pyrophosphate dihydrate (CPPD) and monosodium urate monohydrate crystals in gouty tophi has rarely been reported. We undertook this study to investigate CPPD crystal deposits in a series of surgically removed gouty tophi and to identify factors associated with these deposits.

Methods: Twenty-five tophi from 22 gout patients were analyzed using polarized light microscopy, field emission scanning electron microscopy (FESEM), and μ Fourier transform infrared (μFTIR) spectroscopy. Read More

View Article and Full-Text PDF
February 2021

Tacrolimus induced pseudogout following allogeneic hematopoietic cell transplant.

J Oncol Pharm Pract 2021 Apr 20;27(3):771-775. Epub 2020 Aug 20.

Department of Medicine, Hematology-Oncology Section, Perelman School of Medicine and the Hospital of the University of Pennsylvania, Philadelphia, PA, USA.

Introduction: Crystalline arthritis (CA), characterized by acute joint pain and erythema secondary to calcium pyrophosphate deposition (CPPD, or pseudogout) or monosodium urate crystals (gout), is a potentially underreported complication following allogeneic hematopoietic cell transplant (alloHCT). Graft-versus-host disease prophylaxis with calcineurin inhibitors (CNIs) causes hypomagnesemia and hyperuricemia, resulting in CA. CA related to tacrolimus has yet to be characterized following alloHCT. Read More

View Article and Full-Text PDF

Answer to Checa « Coexistence of gout and chondrocalcinosis instead? », Joint Bone Spine 2020. doi:10.1016/j.jbspin.2020.07.007.

Joint Bone Spine 2020 12 6;87(6):678-679. Epub 2020 Aug 6.

Service de radiologie ostéo-Articulaire, hôpital Lariboisière, AP-HP-Nord, université de Paris, 2, rue Ambroise-Paré, 75010 Paris, France.

View Article and Full-Text PDF
December 2020

Gout and pseudo-gout-related crystals promote GLUT1-mediated glycolysis that governs NLRP3 and interleukin-1β activation on macrophages.

Ann Rheum Dis 2020 11 22;79(11):1506-1514. Epub 2020 Jul 22.

Universite de Paris, Paris, France

Objective: Macrophage activation by monosodium urate (MSU) and calcium pyrophosphate (CPP) crystals mediates an interleukin (IL)-1β-dependent inflammation during gout and pseudo-gout flare, respectively. Since metabolic reprogramming of macrophages goes along with inflammatory responses dependently on stimuli and tissue environment, we aimed to decipher the role of glycolysis and oxidative phosphorylation in the IL-1β-induced microcrystal response.

Methods: Briefly, an in vitro study (metabolomics and real-time extracellular flux analysis) on MSU and CPP crystal-stimulated macrophages was performed to demonstrate the metabolic phenotype of macrophages. Read More

View Article and Full-Text PDF
November 2020