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SAT0526 The Frequency of Calcium Pyrophosphate Deposition Disease in Patients with Acute Arthritis
  1. M. Eliseev,
  2. S. Vladimirov,
  3. E. Nasonov
  1. Research Institute of Rheumatology, Moscow, Russian Federation

Abstract

Background Most of the patients with acute arthritis are diagnosed gout. However, the frequency of Calcium Pyrophosphate Deposition Disease (CPPD) in patients with acute arthritis is not enough valuated.

Objectives To evaluate the frequency of CPPD in patients with acute arthritis and describe joint involvement in these patients.

Methods 150 adults with acute mono-/olygoarthritis during not more than 2 weeks were enrolled. The mean age was 60±12 years (28-76 ys). All patients underwent aspiration of synovial fluid (SF) from inflamed joint (I MTP, knee or ankle). Crystal identification was performed using polarized light microscopy with compensator (Olympus CX31-P). Diagnosis of CPPD fulfilled McCarty diagnostic criteria. For both CPPD and gout the diagnosis was based on crystal visualization in SF.

Results Gout was diagnosed in 51 (34%), CPPD – in 45 (30%) of pts. 15 (14%) of pts occurred to have both CPPD and gout. 39 (26%) of pts had other diagnosis. There was male predominance in pts with gout (40m/11f) unlike CPPD, where we observed female predominance (32f/13m). Pts with gout were younger than those with CPPD (35,5±9 ys vs 58,4±12,8 ys, correspondingly, p<0,05). In CPPD pts arthritis most frequently developed in the knee joints (76,3%). Acute arthritis of the ankle and I MTP joints manifested in 30,3% and 10,5% of pts with CPPD. We noticed that acute arthritis in all pts with gout developed during several hours and only in 1/3 of pts with CPPD. In 2/3 of pts with CPPD acute arthritis developed during 1-2 days. Moreover, we measured the level of pain using VAS (visual analogue scale, mm) in pts. The pain was more severe in pts with gout compared with pts with CPPD (78,4±12,5mm vs 54,3±22 mm, correspondingly) and resolved more rapidly as well (3,4±2 days vs 10,3±3,8 days, correspondingly, p<0,05).

Conclusions Diagnosis of gout and CPPD appeared to occur in pts with acute arthritis with the same frequency. Therefore microcrystal arthritis should be crystal-proven. Acute arthritis resolves significantly more rapid in pts with gout than with CPPD.

Disclosure of Interest None declared

DOI 10.1136/annrheumdis-2014-eular.3500

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