DIAGNOSIS OF PSEUDOGOUT AND SEPTIC ARTHRITIS

A patient with septic arthritis of the wrists was noted to have concurrent calcium pyrophosphate crystals in synovial fluid aspirated from both joints. These were present in unusually large numbers and were associated with destructive changes of the joints. It seemed likely that the complete dissolution of calcified cartilage accounted for the liberation of such numerous crystals. Previous reports of pseudogout associated with septic arthritis have noted the presence of abundant calcium pyrophosphate crystals in synovial fluid. It is suggested that this feature should always raise the possibility of concurrent sepsis. KEY WORDS: Crystals, Synovial fluid, Infection. IT has been recently emphasized that the mis-diagnosis of pseudogout as septic arthritis may result in unnecessary exposure of patients to the hazards of antibiotic treatment [1]. In ordinary rheumatology practice this is not an uncommon experience but, regrettably, infection cannot be excluded by the identification of crystals in syn-ovial fluid. Both sodium monourate and calciu