Acute pseudogout of the foot following Parathyroidectomy: a case report

BACKGROUND: The current case report is the first in the literature to report the association between parathyroidectomy and an episode of probable pseudogout in the foot in a patient with diabetes mellitus. CASE PRESENTATION: The authors present a case of pseudogout of the left foot following a subtotal parathyroidectomy in an 80-year-old female with type 2 diabetes mellitus and primary hyperparathyroidism. Pseudogout, also known as calcium pyrophosphate dehydrate deposition disease, is an unusual metabolic sequela following parathyroidectomy. Pseudogout attacks have been noted in the immediate post-operative period following parathyroidectomy, but has rarely been identified in the foot. The diagnosis was challenging and there were multiple differential diagnoses that were entertained in this case. CONCLUSIONS: This case illustrates the importance of reviewing the surgical history as there might be a link between the previous surgeries and current foot problems. This case also serves as a reminder of the importance of calcium and phosphate metabolism in podiatric health. Most specifically it demonstrates again the association of pseudogout and parathyroidectomy in a patient with diabetes mellitus. Although a rare occurrence, it is an important reminder that metabolic imbalances of calcium levels can manifest in any bone.