痛风影像诊断 课件.ppt

DDX Chondrocalcinosis (pseudogout) Rheumatoid arthritis (RA) Pigmented villonodular synovitis（PVNS） Chondrocalcinosis Commonly found in the elderly Mostly occuring in the knee joint Deposition of different types of crystals in the hyaline articular cartilage and/or fibrous cartilage of the menisci Predominant：Calcium pyrophosphate dihydrate (CPPD) Produce severe degenerative joint disease (pyrophosphate arthropathy) Radiographic hallmarks Articular and periarticular calcification Only involving 1 or 2 joints Discrete areas of low signal intensity within the articular cartilage More apparent on GRE sequences Joint space narrowing Subchondral osteosclerosis Articular surface subsidence 少见原因引起的颅内静脉窦血栓形成课件突发心跳呼吸骤停抢救应急演练课件小学英语教学法英语教学原则阻滞剂在减低非心脏手术 少见原因引起的颅内静脉窦血栓形成课件突发心跳呼吸骤停抢救应急演练课件小学英语教学法英语教学原则阻滞剂在减低非心脏手术 少见原因引起的颅内静脉窦血栓形成课件突发心跳呼吸骤停抢救应急演练课件小学英语教学法英语教学原则阻滞剂在减低非心脏手术 少见原因引起的颅内静脉窦血栓形成课件突发心跳呼吸骤停抢救应急演练课件小学英语教学法英语教学原则阻滞剂在减低非心脏手术 By Bone Group 2013-10-24 CASE DISCUSSION History Male,29Y Complaint:bilateral knee pain with intermittent fever for 4 years Key signs？ Your impression？ DDX？ Laboratory examination Uric Acid（UA）：478.3μmol/L↑ Treatment Allopurinol（ALLO） Final diagnosis Gouty Arthritis Background Gout is a form of inflammatory arthritis that is characterized initially by acute attacks of active synovitis related to the presence of monosodium urate (MSU) crystals in the joints and periarticular soft tissues. Accounting for 3-7％ in panarthritis Men＞40 years old Genetic predisposition Background Most classically in the first metatarsophalangeal joint (toe) A history of underlying renal disease or use of medications that cause hyperuricemia Gold standard : monosodium urate (MSU) crystals in the joint fluid or tophus Pathogenesis MSU crystals Lipids Protein Mucopolysaccharides The tophus eroding the underlying bone is pivotal in the development of bone erosions in gouty arthritis. MSU crystal deposition is associated with the presence of underlying OA. Radiologic hallmark