Crystal arthritis

Abstract

Gout, pseudogout and calcific periarthritis are common causes of acute and chronic inflammation affecting joints and soft-tissues. Accurate diagnosis of these conditions is usually possible and treatment can be highly rewarding both for the patient and the physician. Age has a marked influence on the clinical expression of these conditions. Pseudogout and chronic destructive forms of arthritis are principally conditions of old age whereas in the case of gout the clinical presentation, clinical associations and management all vary considerably between the younger and older age groups. Definitive diagnosis of these conditions relies on the use of polarised light microscopy to identify crystals from an acutely inflamed joint. The diagnosis of crystal induced arthritis should provoke a search for associated diseases or exacerbating factors. Acute episodes regardless, of the aetiology, may respond to non-specific treatment with non-steroidal anti-inflammatory drugs or intra-articular steroids. Once the diagnosis is made then a management plan can be developed in order to treat the acute episode, prevent recurrences and to manage any co-morbid conditions.