When considering referring a patient with pseudogout to a rheumatologist for further evaluation and management, you should consider referral if the diagnosis of the joint condition remains uncertain NICE CKS,NICE NG219. Referral is also appropriate for any adult with suspected persistent synovitis of undetermined cause NICE CKS,NICE NG100.
It is crucial to assess the possibility of septic arthritis, calcium pyrophosphate crystal deposition (pseudogout), and inflammatory arthritis in people presenting with a painful, red, swollen joint NICE NG219. If septic arthritis is suspected, immediate referral according to the local care pathway is necessary NICE NG219.
While specific referral criteria for pseudogout are not detailed in the provided guidelines as they are for gout, the general principles for uncertain diagnosis and persistent inflammatory conditions apply NICE CKS,NICE CKS,NICE NG219,NICE NG100. It is noted that if acute calcium pyrophosphate (CPP) arthritis ('pseudogout') is suspected, it may not follow the urgent referral pathway for new-onset inflammatory arthritis for spondyloarthritis assessment NICE NG65.