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Gout and coexisting pseudogout in the knee joint

  • Yonsik Yoo
  • Young-Jin SeoEmail author
  • Mina Huh
  • Je Hyun Yoo
  • Kyu Ho Yun
  • Sung-Jae Kim
Knee

Abstract

Purpose

We report the unusual case of a 63-year-old man with gout and coexisting pseudogout (calcium pyrophosphate dihydrate crystal deposition disease) affecting the same joint. In this report, we describe the clinical features of the patient in addition to the characteristics of the crystals extracted from his affected joint, examined using compensated polarized microscopy.

Methods

Synovial fluid and specimens of the lateral meniscus of the patient’s knee joint taken during arthroscopy were analyzed using compensated polarized microscopy to evaluate the presence and type of crystals.

Results

Compensated polarized microscopy revealed both monosodium urate (MSU) and calcium pyrophosphate dihydrate (CPPD) crystals extracted from the knee joint.

Conclusions

Our findings suggest that the coexistence of gout and pseudogout should be considered in the diagnosis of crystal-induced arthritis. Careful crystal evaluation using compensated polarized microscopy may reveal similar cases with MSU and CPPD crystals in the same joint.

Keywords

Knee Pseudogout Gout Arthroscopy 

Notes

Conflict of interest

There are no conflicts of interest to disclose for this study.

References

  1. 1.
    Bari CD, Lapadula G, Cantatore P (1998) Coexisting psoriatic arthritis, gout and chondrocalcinosis. Scand J Rheumatol 27:306–309PubMedCrossRefGoogle Scholar
  2. 2.
    Bob D, Bruce W, Charles J, Susan VW, Shreveport L (1987) Gout and pseudogout of the temporomandibular joint. Oral Surg, Oral Med, Oral Pathol 63:551–554CrossRefGoogle Scholar
  3. 3.
    Cassetta M, Gorevic PD (2004) Crystal arthritis: Gout and pseudogout in geriatric patient. Geriatrics 59:25–31PubMedGoogle Scholar
  4. 4.
    Dieppe PA, Alexander GJM, Jones HE (1982) Pyrophosphate arthropathy: a clinical and radiological study of 105 cases. Ann Rheum Dis 41:371–376PubMedCrossRefGoogle Scholar
  5. 5.
    Ellman MH, Levin B (1975) Chondrocalcinosis in elderly persons. Arthritis Rheum 18:43–47PubMedCrossRefGoogle Scholar
  6. 6.
    Felson DT, Anderson JJ, Naimark A, Kannel W, Meenan RF (1989) The prevalence of chondrocalcinosis in the elderly and its association with knee osteoarthritis: the Framingham study. J Rheumatol 16:1241–1245PubMedGoogle Scholar
  7. 7.
    Jones AC, Chuck AJ, Arie EA (1992) Diseases associated with calcium pyrophosphate deposition disease. Semin Arthritis Rheum 22:188–262PubMedCrossRefGoogle Scholar
  8. 8.
    McCarty DJ (1988) Crystal identification in human synovial fluids. Rheum Dis Clin North Am 14:253–267PubMedGoogle Scholar
  9. 9.
    McCarty DJ, Kohn NN, Faires JS (1962) The significance of calcium phosphate crystals in synovial fluid of arthritic patients: the “pseudogout syndrome”. Ann Intern Med 56:711–737Google Scholar
  10. 10.
    Pascual E, Doherty M (2009) Aspiration of normal or asymptomatic pathological joints for diagnostic research: indications, technique and success rate. Ann Rheum Dis 68:3–7PubMedCrossRefGoogle Scholar
  11. 11.
    Saliba I, Bouthiller A, Desrochers P, Berthlet F, Dufour JJ (2003) Tophaceous gout and pseudogout of the middle ear and the infratemporal fossa: case report and review of the literature. J Otolaryngol 32:269–272PubMedCrossRefGoogle Scholar
  12. 12.
    Stockman A, Darlington LG, Scott JT (1980) Frequency of chondrocalcinosis of the knees and avascular necrosis of the femoral heads in gout: a controlled study. Ann Rheum Dis 39:7–11PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • Yonsik Yoo
    • 1
  • Young-Jin Seo
    • 1
    Email author
  • Mina Huh
    • 1
  • Je Hyun Yoo
    • 1
  • Kyu Ho Yun
    • 1
  • Sung-Jae Kim
    • 2
  1. 1.Center for Arthroscopy, Department of Orthopaedic SurgeryHallym University Hangang Sacred Heart HospitalSeoulKorea
  2. 2.Arthroscopy and Joint Research InstituteYonsei University Medical CenterSeoulKorea

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