Gout / Pseudogout


  • Negatively birefringent needle-shaped
  • Crystals of monosodium urate.
  • 40-50 yrs (men), > 60 yrs (women)
  • Any joint
  • Hallux MTP is involved in over 50% of first attacks.The white count on arthrocentesis can be v high

Hydroxyapatite crystal arthritis:

  • Calcific periarthritis.
  • Shoulder.
  • Attacks precipitated by mild trauma or intercurrent infection
  • Associated with scleroderma, hyperparathyroidism, dermatomyositis, inflammatory joint disease, and OA

Oxalate and lipid crystals can both cause a crystal arthropathy.


  • Positively birefringent rhomboidal crystals of
  • Calcium pyrophosphate dihydrate.
  • 60s to 70s, (F>M)
  • Most common cause of acute arthropathy in the elderly
  • Classically knees
  • Predisposing factors include haemochromatosis, hyperparathyroidism, hypomagnesaemia, hypophosphatasia, Wilson’s disease, gout and ochronosis.
  • Triggers include trauma, intercurrent ilnness, joint aspiration and blood / fluid infusion
  • More.....

Management acute gout

Content by Dr Íomhar O' Sullivan 10/09/2003. Reviewed br Dr ÍOS 15/03/2004, 25/95/2005, 22/05/2007, 19/06/21. Last reviewed Dr ÍOS 19/06/21.