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Hydroxyapatite pseudopodagra

Hydroxyapatite pseudopodagra is acute calcific periarthritis occurring near the first metatarsophalangeal (MTP) joint, causing podagra identical to that seen in gout. This presentation is more common in young women who excessively pronate their feet; walking or running causes repetitive trauma to this area. The condition may be distinguished from gout according to the premenopausal status of the patient, the absence of monosodium urate crystals in synovial fluid, and characteristic calcifications around the joint on roentgenography. Symptoms subside over several weeks, either spontaneously or with treatment. Interestingly, the calcific deposit may dissolve during the acute inflammatory episode, leading to disappearance of the calcification on follow-up roentgenograms. This can also occur in other joint areas as the finger: Philadelphia-Finger.