Seniors often have inflammatory joint illnesses like gout and pseudogout. This case report describes a rare combined occurrence of both illnesses.
A 42-year-old guy complained of right knee discomfort and edema for two days at the emergency room. The pain was spontaneous and trauma-free. For two years, the patient had recurring right knee problems.
The physicians reviewed his right knee arthrocentesis (joint aspiration) findings, which showed negatively birefringent crystals for which he was taking colchicine. Grade 3 right knee chondromalacia, asthma, and ischemic heart disease were mentioned in his medical history.
Examination for Pseudogout and Gout
The physicians found the right knee warm, painful, erythematous, and effusion-prone during a general physical. Also, discomfort limited his mobility. Leukocyte count, erythrocyte sedimentation rate, C-reactive protein, and uric acid were also raised in his labs.
Radiological imaging indicated right knee medial compartment narrowing and degeneration. Joint calcification was not found by radiography. Additionally, joint fluid aspiration showed turbid, straw-colored fluid with high neutrophilic count. Culture and staining were negative, however microscopic examination revealed few positive and negative birefringence crystals. These data supported pseudogout and joint gout diagnoses.
The treatment comprised colchicine and physiotherapy. Due to ischemic heart disease, physicians did not give NSAIDs. Doctors also avoided allopurinol to prevent gout flares. He received paracetamol and tramadol for pain. Patient improved following therapy and released after two days.
