Which disorders should be considered in the differential diagnoses of gout and pseudogout?

Updated: Jan 26, 2021
  • Author: Bruce M Rothschild, MD; Chief Editor: Herbert S Diamond, MD  more...
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Answer

Patients who present with acute inflammatory arthritis need to undergo arthrocentesis to exclude septic arthritis, even if their serum uric acid level is elevated. Nongonococcal infectious arthritis carries a 10% fatality rate and therefore must be excluded.

Other problems to be considered in the differential diagnosis of gout and pseudogout include the following:

  • Acute sarcoidosis
  • Amyloidosis
  • Bursitis
  • Calcific periarthritis
  • Chondrocalcinosis
  • Congenital fructose intolerance
  • Conjunctival calcinosis
  • Hyperparathyroidism
  • Hypoxanthine-guanine phosphoribosyltransferase deficiency (Lesch-Nyhan syndrome)
  • Malignant soft tissue tumors
  • Milk-alkali syndrome
  • Multicentric reticulohistiocytosis
  • Paronychia
  • Pigmented villonodular synovitis
  • Phosphoribosylpyrophosphate synthetase superactivity
  • Psoriatic arthropathy
  • Reactive arthritis
  • Renal osteodystrophy
  • Spondyloarthropathy
  • Rheumatoid arthritis
  • Tenosynovitis
  • Trauma
  • Type IIA hyperlipoproteinemia

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