No More Blind Betting (With Ultrasound), When Rolling the Dice on Crystal Arthropathy!

Abstract

Emergency physicians routinely treat acute arthritis with anti-inflammatory medications and discharge patients with the diagnosis of gout. However, when patients return days later with worsening symptoms, the probability of it involving calcium pyrophosphate crystals requiring completely different management prevails. Crystal misdiagnosis has its consequences. Research shows up to 40% of patients diagnosed with gout actually have pseudogout (calcium pyrophosphate crystal arthropathy) when properly analyzed.1 This misidentification leads to treatment failure in over 60% of cases, with patients receiving colchicine for presumed gout when they actually need anti-inflammatory therapy for calcium pyrophosphate arthropathy.