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Related Experiment Videos

Pseudogout attack induced during etidronate disodium therapy.

Hiroshi Watanabe1, Sayaka Yamada, Satoshi Anayama

  • 1Department of Orthopedics, Faculty of Medicine, Yamanashi University, 1110 Shimokato, Tamahocho, Nakakoma, Yamanashi, 409-3898, Japan. hiroshiw123@aol.com

Modern Rheumatology
|April 25, 2006
PubMed
Summary

Etidronate disodium therapy can trigger pseudogout attacks in the distal interphalangeal joints, especially in elderly patients with Heberden's nodes. This adverse drug reaction requires careful consideration during bisphosphonate treatment.

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Area of Science:

  • Rheumatology
  • Pharmacology
  • Geriatrics

Background:

  • Osteoporosis management often involves bisphosphonate therapy, such as etidronate disodium.
  • Elderly individuals are susceptible to metabolic changes affecting calcium, potentially predisposing them to crystal-induced arthritis.
  • Distal interphalangeal joint arthritis, commonly presenting as Heberden's nodes, is prevalent in older populations.

Observation:

  • A 64-year-old woman developed severe pain, swelling, and skin ulcers in her distal interphalangeal joints during etidronate disodium treatment for osteoporosis.
  • Synovial fluid analysis confirmed the presence of monoclinic calcium pyrophosphate crystals, indicative of a pseudogout attack.
  • Symptoms resolved rapidly following treatment with oral loxoprofen sodium.

Findings:

Related Experiment Videos

  • This case represents the first documented instance of pseudogout attack specifically affecting the distal interphalangeal joints during etidronate disodium therapy.
  • The patient's pre-existing Heberden's nodes may have contributed to the localized manifestation of pseudogout.
  • The temporal association suggests a potential drug-induced etiology for the pseudogout attack.

    • Implications:

    • Clinicians should consider pseudogout attack as a potential adverse drug reaction in elderly patients receiving bisphosphonates, particularly those with pre-existing distal interphalangeal joint disease.
    • This finding highlights the importance of monitoring for atypical presentations of crystal arthropathy during bisphosphonate therapy.
    • Further research may be warranted to elucidate the mechanisms linking bisphosphonates to pseudogout in specific joint locations.