Gout and coexisting pseudogout in the knee joint.
OBJECTIVE
We report the unusual case of a 63-year-old man with gout and coexisting pseudogout (calcium pyrophosphate dihydrate crystal deposition disease) affecting the same joint. In this report, we describe the clinical features of the patient in addition to the characteristics of the crystals extracted from his affected joint, examined using compensated polarized microscopy.


METHODS
Synovial fluid and specimens of the lateral meniscus of the patient's knee joint taken during arthroscopy were analyzed using compensated polarized microscopy to evaluate the presence and type of crystals.


RESULTS
Compensated polarized microscopy revealed both monosodium urate (MSU) and calcium pyrophosphate dihydrate (CPPD) crystals extracted from the knee joint.


CONCLUSIONS
Our findings suggest that the coexistence of gout and pseudogout should be considered in the diagnosis of crystal-induced arthritis. Careful crystal evaluation using compensated polarized microscopy may reveal similar cases with MSU and CPPD crystals in the same joint.
Yoo
Yonsik
Y
Center for Arthroscopy, Department of Orthopaedic Surgery, Hallym University Hangang Sacred Heart Hospital, 94-200 Youngdeungpo-Dong, Youngdeungpo-Ku, 150-719, Seoul, Korea.
Seo
Young-Jin
YJ
Huh
Mina
M
Yoo
Je Hyun
JH
Yun
Kyu Ho
KH
Kim
Sung-Jae
SJ
D001182:Arthroscopy / Q000379:methods*; D002131:Calcium Pyrophosphate / Q000032:analysis; D002805:Chondrocalcinosis / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D003646:Debridement / Q000379:methods; D004636:Emergency Service, Hospital; D005500:Follow-Up Studies; D006073:Gout / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D006801:Humans; D007719:Knee Joint; D008297:Male; D008875:Middle Aged; D010808:Physical Examination / Q000379:methods; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014527:Uric Acid / Q000032:analysis
D014527:Uric Acid; D002131:Calcium Pyrophosphate
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