The only notable finding from the patient’s peripheral laboratory data (CBC, chemistry) is a creatinine of 2.1 mg/dL. What is the best treatment for this patient?
A. Colchicine
B. Indomethacin
C. Intra-articular methylprednisone
D. Morphine
E. Surgical irrigation and debridement
Answer
Choice “C” is the best answer. This patient has acute pseudogout which has the same treatment as acute gout. Colchicine and indomethacin are the mainstays of pharmacotherapy but are contraindicated in patients with renal disease. This patient has a creatinine of 2.1 mg/dL, which is correlated with an eGFR of 33 mL/min and represents stage 4 chronic renal failure. Both colchicine and indomethacin should be avoided. Intra-articular steroids can be safely used
A. Colchicine
B. Indomethacin
C. Intra-articular methylprednisone
D. Morphine
E. Surgical irrigation and debridement
Answer
Choice “C” is the best answer. This patient has acute pseudogout which has the same treatment as acute gout. Colchicine and indomethacin are the mainstays of pharmacotherapy but are contraindicated in patients with renal disease. This patient has a creatinine of 2.1 mg/dL, which is correlated with an eGFR of 33 mL/min and represents stage 4 chronic renal failure. Both colchicine and indomethacin should be avoided. Intra-articular steroids can be safely used