Wheeler A P, Graham B S
Am J Med Sci. 1985 Feb;289(2):68-9. doi: 10.1097/00000441-198502000-00006.
A man developed acute monoarticular ankle arthritis caused by calcium pyrophosphate dihydrate (CPPD) crystals. The clinical syndrome resembled that of a pyogenic arthritis. Synovial fluid analysis revealed a glucose concentration of 13 mg/dL and 99,000 white blood cells/mm3. Only one other report of an extremely low synovial fluid glucose associated with pseudogout could be found. The diagnosis of pseudogout was initially suggested when rhomboidal forms were seen during synovial fluid Gram stain examination. Synovial fluid examination with polarized microscopy was initially negative, but revealed numerous CPPD crystals when repeated on the third hospital day. This case serves to illustrate how pseudogout can mimic pyogenic arthritis in both clinical presentation and low synovial fluid glucose concentration. The examination of Gram-stained synovial fluid can reveal the rhomboidal forms of CPPD crystals. The appearance of these crystals is documented in this report.
一名男子患上了由二水焦磷酸钙（CPPD）晶体引起的急性单关节踝关节关节炎。临床综合征类似于化脓性关节炎。滑液分析显示葡萄糖浓度为13mg/dL，白细胞计数为99,000/mm³。仅发现另一例与假性痛风相关的滑液葡萄糖极低的报告。当在滑液革兰氏染色检查中看到菱形形态时，最初提示为假性痛风诊断。偏振显微镜检查滑液最初为阴性，但在住院第三天重复检查时发现了大量CPPD晶体。该病例说明了假性痛风在临床表现和滑液葡萄糖浓度低方面如何模仿化脓性关节炎。革兰氏染色的滑液检查可揭示CPPD晶体的菱形形态。本报告记录了这些晶体的外观。
