A 67-year-old woman had an 8jear history of chronic polyarthritis associated with extensive chondrocalcinosis. Synovial biopsy on two occasions showed crystalline material in the synovium, associated with chronic granulomatous reaction. Polarizing microscopy studies suggested the presetnce of both calcium pyrophosphate dihydrate and dicalcium phosphate dihydrate crystals. Electron diffraction studies were also consistent with the presence of a mixed crystal population. The chronic arthritis seen appears to be the result of chronic synovial inflammation induced by calcium crystal deposits.

Diabetic ketoacidosis (DKA) is one of the serious complications of diabetes, especially type 1. It is defined by the triad of hyperglycemia (>250 mg/dL [>13.9 mmol/L]), high anion-gap metabolic acidosis, and increased plasma ketones. Euglycemic ketoacidosis is characterized by DKA without hyperglycemia. We present a rare case of a 28-year-old type 1 diabetic male, presenting with abdominal pain, fatigue, and dizziness after one week of starting a keto diet. He was diagnosed with euglycemic DKA, managed with DKA protocol and given detailed dietary counselling to avoid the keto diet in future.