Gout also has a "fake"? 6 joint diseases to be identified! Experts are playing fakes like this...

Don't want to miss Jiemei's push? Poke the blue word "medical rheumatism and nephropathy channel" to pay attention to us and click the "·" menu in the upper right corner and select "set as star" today, have you learned to crack down on counterfeit goods? Editor's note: on April 20, the theme activity of "fighting gout, we are in action" jointly launched by "rheumatism and nephropathy channel of medical circles" and Clinical Immunology Department of Xijing Hospital of Air Force Military Medical University is still continuing. We will continue to release clinical experience sharing and expert opinions of Clinical Immunology doctors in Xijing Hospital, aiming at popularizing scientific knowledge, helping standardized diagnosis and treatment of gout Please pay attention! This issue is the gout diagnosis and treatment of Professor Ding Jin, Xijing Hospital, Air Force Military Medical University. Let's have a look at it! With the improvement of living standards, more and more people around us suffer from gout, and we are more and more familiar with gout.but did you know that gout can also be fake! Let the clinician teach you how to crack down on counterfeit goods.what is "pseudo gout"? First, let's take a look at "pseudo gout.".gout is caused by the deposition of urate crystals in the joint. As like as two peas,, however, calcium pyrophosphate dehydrate deposition (CPPD) can also lead to almost the same symptoms as gout, and is therefore considered "pseudo gout".it is called calcium pyrophosphate deposition in medicine. It is a kind of joint disease with diverse clinical manifestations caused by calcium pyrophosphate crystal deposition. The prevalence of CPPD increased with age.most patients are asymptomatic, and the cause of CPPD deposition is unknown.a small number of people with metabolic abnormalities or genetic diseases, such as hyperparathyroidism, dependence on hemodialysis, hemochromatosis, hypomagnesemia and so on, can appear at an earlier age.for hypothyroidism, thyroid hormone supplementation may induce pseudo gout.both of them have joint pain, so how to distinguish gout from pseudo gout? First of all, gout is more common in middle-aged men and women in postmenopausal women. Of course, gout is becoming younger and younger in recent years.however, pseudogout is more common in the elderly after 60 years old, and there is no clear distinction between men and women.secondly, gout mostly starts from the toe joint, while the onset of pseudo gout often starts from the knee joint, usually involving single joint, and can also involve ankle joint, palm joint, wrist joint, elbow joint and shoulder joint.of course, the final diagnosis depends on the doctor. For typical gout, high uric acid is found by blood test, joint fluid examination and imaging examination such as dual energy CT; while pseudogout requires imaging examination (dot or linear calcification spot of cartilage on X-ray film of joint), extracting fluid from joint and placing it under microscope to find calcium pyrophosphate crystal Can be diagnosed, pseudogout patients often blood uric acid is normal.these five kinds of joint diseases should also be differentiated from gout! In addition to pseudogout, there are many joint diseases that can cause gout like symptoms.what is the difference between gout and other joint diseases? Septic arthritis and traumatic arthritis, traumatic arthritis generally has a history of joint trauma, lasting for a long time, while the joint site of suppurative arthritis can extract purulent joint fluid, there are a large number of white blood cells, and can cultivate pathogenic bacteria.the serum uric acid of both groups was not high, and there was no urate crystal in synovial fluid examination.rheumatoid arthritis is common in young and middle-aged women. It often occurs in small joints such as fingers and wrists. It is mostly symmetrical polyarthritis with morning stiffness. Repeated attacks can cause joint deformity. rheumatoid factor and anti CCP antibody were positive, but serum uric acid was not high. the X-ray film shows that the articular surface is rough and the joint space is narrow. In the late stage, it can be related to arthrodesis, but the bone perforation like defect is not as obvious as gout, and there is no formation of tongfengshi. periarticular cellulitis periarticular cellulitis the soft tissue around the joint is more red and swollen, with chills, fever and other systemic symptoms, but joint pain is often not as significant as gout, blood leukocyte count is significantly increased, and blood uric acid is normal. psoriatic arthritis psoriatic arthritis often has a history of psoriasis (psoriasis), as well as asymmetric multi joint pain, fingertip (toe) inflammation, low back pain or hip joint pain. reactive arthritis before the onset of reactive arthritis, there are often respiratory tract infection, intestinal or urinary tract infection and other medical history, more common in young people, uric acid level is not high, lower limb joints are more common, sausage toe of foot can appear, and some patients will have low back pain. lengnan often performs the following scenes in the outpatient department of rheumatology. A patient walks into the consulting room, holding up a test sheet with blood and urine acid slightly higher than normal, and anxiously asks "doctor, am I suffering from gout?" Not to mention whether the patient really suffered from gout, but this phenomenon at least illustrates several problems: first, gout is not a new name to the public; second, many people know that the disease will have elevated blood uric acid and joint symptoms; of course, there are also three... Four However, what the patients don't know is that apart from the deviation of blood uric acid level caused by many factors, joint swelling and pain is not the patent of gout In this section, Dr. Ding Jin clearly tells you that gout also has "false", whether calcium pyrophosphate deposition, or suppurative arthritis, traumatic arthritis and rheumatoid arthritis and many other diseases may have some joint manifestations like gout In other words, when we have joint symptoms, the correct way is to go to the regular hospital, do the corresponding examination, in order to clarify the real cause of joint swelling and pain, then we can prescribe the right medicine to the case, in order to eliminate the disease. Prof. Leng Nan, deputy chief physician and associate professor of Clinical Immunology Department of Xijing Hospital. he is also the deputy chairman of Rheumatology and Immunology branch of Shaanxi Medical Doctor Association, the executive director of rheumatism and molecular immunity branch of National Health Industry Enterprise Management Association, and the Standing Committee member of rheumatism branch of Shaanxi Medical Association. deputy editor in chief, 2 textbooks participated in the compilation. independently wrote "Pandora's box opened: a full interpretation of AIDS". he has undertaken / participated in many scientific research projects, such as the military special drug confidentiality project, the National Natural Science Foundation key project, the national science and technology major special sub project, the creation of major new drugs, and the discipline promotion program of Xijing Hospital. in 2005, he won the second prize of military science and technology progress award, one third prize of school level teaching achievement award, and one first prize of science and technology award of China Pharmaceutical Association in 2008. Specialty: immune mediating mechanism and new diagnosis and treatment technology of immune diseases and rheumatic diseases. he is specialized in the diagnosis and treatment of difficult and critical rheumatic diseases, allergic diseases, low immune function and viral hepatitis. Professor Ding Jin, female, associate chief physician, Department of clinical immunology, Xijing Hospital, Air Force Military Medical University, MD. long term engaged in rheumatic disease clinical, scientific research, teaching and other work, good at ankylosing spondylitis, rheumatoid arthritis, systemic lupus erythematosus, vasculitis and other rheumatic diseases and the diagnosis and treatment of a variety of medical difficult and miscellaneous diseases. visited Houston Medical Center for one year. presided over one National Natural Science Foundation and one natural science foundation of Shaanxi Province, and participated in a number of national research projects. at present, she has published more than ten articles in SCI, participated in international and national academic conferences and edited many monographs.