Gout and Pseudogout-Crystal Arthropathies (2026 IMCU)

Learning Objectives:

• Distinguish the clinical, synovial fluid, and polarized microscopy features of gout (MSU), pseudogout (CPPD), and BCP deposition disease, and apply these distinctions to guide appropriate diagnostic workup and initial management.
• Apply Urate-Lowering Therapy Principles Identify evidence-based indications for urate-lowering therapy (ULT), select appropriate first- and second-line agents based on patient comorbidities (including CKD, cardiovascular disease, and pharmacogenomics such as HLA-B*5801 status), and implement a treat-to-target strategy with concurrent flare prophylaxis.
• Enumerate the extra-articular manifestations of gout (renal, cardiovascular, metabolic) and CPPD (crowned dens syndrome, atypical OA), and explain why comprehensive management—including treatment of underlying metabolic disorders and cardiovascular risk reduction—is essential to improve patient outcomes beyond joint disease.