Evidence map›Paper›PMID 40522365›Full record

ArticleArchives of orthopaedic and trauma surgery2025

Steroid or pseudogout? Analysis of white deposits in tissues during surgery.

Chris Lamprecht, Lacie Turnbull, Alex Barnett, Elham Nasri, Miqi Wang

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Article in Archives of orthopaedic and trauma surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1citing papers in PubMed
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1 · What the graph read from it

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1 citing paper in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

5 authors.

Chris LamprechtUniversity of Florida College of Medicine , Gainesville, USA. chrislamprecht@ufl.edu.
Lacie TurnbullUniversity of Florida College of Medicine , Gainesville, USA.
Alex BarnettUniversity of Florida College of Medicine , Gainesville, USA.
Elham NasriUniversity of Florida College of Medicine , Gainesville, USA.
Miqi WangUniversity of Florida College of Medicine , Gainesville, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionPseudogout is characterized by the deposition of calcium pyrophosphate crystals in the pericellular matrix of chondrocytes. Pseudogout flares can present similar to gout, osteoarthritis, septic arthritis, or prosthetic joint infection, potentially complicating post-surgical outcomes. With a high prevalence among patients undergoing arthroplasty, appropriate awareness is essential to mitigate misdiagnosis and inappropriate treatment. This study reviews a series of eight patients in whom white deposits are identified intraoperatively and seeks to guide identification, patient education, and future treatment for pseudogout.

methodsPatients undergoing surgical intervention were assessed for the presence of an intraarticular white substance. When the substance was identified, a sample was sent for assessment by a pathologist. The patients' age, sex, pertinent history, surgery, site of biopsy, and pathologist findings were documented.

resultsOf the eight patients included in the study, the average age was 67.9 years (range 62-75). Five (62.5%) were male and three (37.5%) were female. Six (75%) were found to have CPPD crystals. Out of these six, one had a steroid injection 5 months prior and another 7 months prior. One patient who had a steroid injection 4 months prior to surgery had a scant amount of white substance that was identified as "acellular material" by the pathologist. Only a single patient of these six had a standing diagnosis of pseudogout prior to surgery. Intraoperatively, the white substances were visually similar in all cases.

conclusionsThere is a high prevalence of pseudogout in patients over the age of 65 and with concurrent arthritis. Presentation of pseudogout can range from asymptomatic to mimicking septic arthritis. Unidentified white substances noted intraoperatively should be sent to pathology for identification. In patients with pseudogout, it is important to educate the patient and consider prophylactic treatment to minimize risk of recurrence and damage to other joints.

Indexed as

ChondrocalcinosisAgedDiagnosis, DifferentialFemaleHumansMaleMiddle AgedChondrocalcinosisCPPDIntraoperative substance identificationPseudogout

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