両足第１ＭＴＰ関節に発症した偽痛風（ｐｓｅｕｄｏｐｏｄａｇｒａ）の一例

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  • A Case of Pseudopodagra.

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We recently performed surgical treatment for pseudopodagra. A 55-year-old male who was suffering from pain in his right big toe for 3 months visited our hospital. Systemic chondrocalcinosis was observed in the left big toe, from which a calcified mass had already been resected, and in the bilateral knees, bilateral wrists, the right Achilles tendon, and the left heel. The patient was initially treated with nonsteroidal anti-inflammatory drugs (NSAID), which did not completely alleviate symptoms. Therefore we resected the calcified mass from his first metatarsophalangeal (MTP) joint and did a synovectomy of his first MTP joint. The specimens obtained from the MTP joint were examined by light microscopy, compensated polarized light microscopy, and then by scanning electron microscopy. Results showed that the calcified crystals were deposits of calcium pyrophosphate dehydrate. We concluded that surgical treatment should be done in the case of repeated attacks, and it is necessary to resect not only crystals but also the surrounding tissue of the affected area.

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