What Is Pseudoarthrosis?

Pseudo-gouty arthritis is a joint disease with diverse clinical manifestations caused by the deposition of calcium dihydroxypyrophosphate crystals, including intermittent onset of acute arthritis; degenerative joint disease, sometimes severe and sometimes asymptomatic. An image of calcium deposits of articular cartilage was seen in specific areas.

Basic Information

English name

pseudogout arthritis

Visiting department

orthopedics

Multiple groups

Middle-aged and elderly after 30

Common causes

Caused by crystal deposition of calcium dihydroxy pyrophosphate

Common symptoms

Diverse arthropathy, including intermittent episodes of acute arthritis; degenerative joint disease, sometimes severe and sometimes asymptomatic

Clinical manifestations of pseudogouty arthritis

The age of onset of this disease is mostly middle-aged and elderly after 30 years old, which is similar to gout. According to the clinical manifestations of this disease, it can be divided into the following 7 types:

1. Type I

It is characterized by an acute or subacute, self-limiting arthritis attack involving one or more small joints, with an onset of time ranging from one day to several weeks, usually with mild pain. This type is best to invade the knee, but the hip, shoulder, elbow, wrist, ankle, etc. can be affected.

2. Type II

It is characterized by persistent, acute-onset arthritis, and symptoms can last from 4 weeks to months. At the same time, the blood sedimentation speeded up.

3. Type III

This type is most common and manifests as chronic progressive arthritis, with occasional acute infections. Large joints are involved symmetrically, such as the knee, hip, and metacarpophalangeal, elbow, ankle, wrist, and shoulder joints. It is characterized by bilateral symmetrical involvement and flexion contractures, especially the knee and elbow joints.

4. Type IV

This type of clinical feature is chronic progressive arthritis without acute exacerbations. Such as type III, its performance is similar to degenerative joint disease.

5. Type V

Asymptomatic joint disease, this clinical type has the highest incidence.

6. Type VI

It is a rare clinical type of calcium dihydroxypyrophosphate crystalosis.

7.type

A variety of morphological mixed types, the least common type of this disease, clinical manifestations can also be similar to ankylosing spondylitis.

False gouty arthritis test

This disease mostly uses imaging methods, and its performance mainly includes the following aspects:

Cartilage calcification

The most commonly affected areas are the knee, wrist, pubic symphysis, elbows, and hips. Involved cartilage includes fibrocartilage and hyaline cartilage.

Synovial calcification

This calcification usually coexists with cartilage calcification. Synovial deposits are most common in the wrist, especially around the radial wrist joint, inferior radius ulnar joint, knee joint, metacarpophalangeal joint, and metatarsophalangeal joint; it can also be found in the humerus glenoid, elbow, Hip and acromioclavicular joints. The deposits are cloud-like, especially at the edges of the joints, and may be similar to idiopathic synovial osteochondromatosis.

3. Joint capsule calcification

Calcium dihydroxy pyrophosphate crystals are deposited in the joint capsule, most commonly in the elbow and metatarsophalangeal joints, but also in the metacarpophalangeal and shoulder-humeral joints.

4. Calcification of tendons, bursae, and ligaments

Tendon and ligament calcification may occur. Common sites are the Achilles tendon, triceps, quadriceps and supraspinous tendon, and acromicular bursa; sometimes it is also seen in the suprapatellar bursa. The calcification of tendons is thin and linear, extending from the edge of the bone to a considerable distance.

5. Soft tissue and vascular calcification

In some patients, calcifications in the soft tissues and blood vessels are visible, with calcifications with unclear boundaries. Soft tissue calcification is most common in the elbow, wrist, and pelvic regions. Vascular calcification may be associated with comorbid diabetes.

Diagnosis of pseudogouty arthritis

1. Two or more joints show typical hyaline cartilage or fibrocartilage calcification, and intervertebral disc calcification is not included.

2. Aspiration fluid from the joints with or without symptoms, microscopic examination, can see monoclinic or polyclinic crystals, lacking or showing weak positive birefringence.

Treatment for pseudogouty arthritis

In the acute phase

General treatments for acute arthritis should be used, including joint braking and joint drainage.

2. Patients who have calcification in meniscus and similar meniscus interlocking

Meniscalectomy should be performed. At the same time, the joint cavity should be explored to remove osteophytes and free bodies, etc., to eliminate the factors that hinder the function of joint activities, and to avoid the formation of osteoarthritis.

3. Drug treatment

Intravenous boluses of colchicine were used and diluted with 0.9% sodium chloride. When the acute synovial membrane is exuded, the exudate must be removed. Check for crystals in the exudate, and then inject adrenocortical hormone into the joint.