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Diuretics and Hyperuricaemia — SCE Rheumatology MCQ

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HardCrystal ArthropathyDiuretics and HyperuricaemiaSCE Rheumatology

A 43-year-old has recurrent acute calcium-pyrophosphate crystal arthritis. Radiographs show chondrocalcinosis and hook-like osteophytes at the second and third MCP joints. Which investigation is most specifically prompted by this pattern?

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Correct answer: B — Transferrin saturation and serum ferritin for iron overload

CPPD presenting before the usual age plus hook-like osteophytes at the second and third MCP joints is a classic clue to haemochromatosis arthropathy. Iron studies should include transferrin saturation and ferritin, followed by HFE testing when biochemical iron overload is present; other metabolic associations can be assessed in parallel according to the wider phenotype.

Reference: EULAR recommendations for calcium pyrophosphate deposition management (Published 2011): https://ard.bmj.com/content/70/4/571; NHS: haemochromatosis diagnosis (Reviewed 2023; current NHS guidance accessed July 2026): https://www.nhs.uk/conditions/haemochromatosis/diagnosis/