Description

Pseudogout (SOO-doe-drop) is a form of arthritis that is characterized by sudden, painful swelling in one or more of the joints. The episodes can last for days or weeks.

Pseudogout is formally known as deposition disease calcium pyrophosphate or CPPD. But the condition is commonly called pseudogout, due to its similarity to gout. In both pseudogout and gout, the crystal deposits form within a joint, although the type of crystal differs for each condition.

It is not clear why crystals form in the joints and cause pseudogout, but the risk increases with age. The treatments can help relieve the pain and reduce inflammation.

Symptoms

Pseudogout most commonly affects the knees. Less often, it affects the wrists and ankles. When a pseudogout attack occurs, the affected joints are usually:

  • Swollen
  • Hot
  • Very painful

When to see a doctor

Seek medical attention if you have severe pain and sudden pain in the joints and inflammation.

Causes

Pseudogout has been linked to the presence of calcium pyrophosphate dihydrate crystals in the affected joint. These crystals are more numerous as people age, appearing in almost half of the population above 85 years of age. But most of the people who have these crystal deposits never develop pseudogout. It is not clear why some people have symptoms and others do not.

Risk factors

Factors that may increase your risk of pseudogout include:

  • Advanced age. The risk of developing pseudogout increases with age.
  • Joint Trauma. The Trauma of the joint, such as a serious injury or surgery, increases the risk of pseudogout in the joint.
  • Genetic disorder. In some families, members of the family have an inherited tendency to develop pseudogout. These people tend to develop pseudogout at young ages.
  • Mineral imbalances. The risk of pseudogout is greater for people who have excess calcium or iron in the blood, or the lack of magnesium.
  • Other medical conditions. Pseudogout has also been linked to an underactive thyroid gland or an overactive parathyroid gland.

Complications

The crystal deposits associated with pseudogout can also cause damage to the joints, which can mimic the signs and symptoms of osteoarthritis or rheumatoid arthritis.

Diagnosis

Pseudogout symptoms may resemble those of gout and other types of arthritis, as well as lab and imaging tests are usually needed to confirm a diagnosis.

Tests

Blood tests can check for problems with the thyroid and parathyroid glands, as well as by the imbalances of minerals that have been linked to pseudogout.

To test the fluid in the joint affected by the presence of crystals, your health care provider can remove a sample of the fluid with a needle. This procedure is called a joint aspiration (arthrocentesis).

X-rays of the affected joint can often reveal the damage to the joints, and deposits of crystals in the joints cartilage.

Treatment

There is No cure for pseudogout, but a combination of treatments can help relieve pain and improve joint function.

Drugs

If over-the-counter pain relievers are not enough, your doctor may suggest:

  • Nonsteroidal anti-inflammatory drugs (Nsaids). The prescription-strength Nsaids include naproxen (Naprosyn) and indomethacin (Indocin). Nsaids can cause stomach bleeding and decreased renal function, especially in older adults.
  • Colchicine (Colcrys, Mitigare). Low-dose pills of this drop of drugs are also effective for pseudogout. If you have frequent episodes of pseudogout, it may be advisable to take colchicine daily as a preventive measure.
  • Corticosteroids. If you can't take Nsaids or colchicine, your health care provider may suggest that you take corticosteroid pills, such as prednisone, to reduce inflammation and end the attack. Prolonged use of corticosteroids can weaken the bones and cause cataracts, diabetes, and weight gain.

Drain assembly

The removal of some of that fluid out of the joint can relieve pain and pressure in an affected joint. A needle is used to extract the liquid. The process also helps to remove some of the crystals in the joint. The joint is then injected with a numbing medicine and a corticosteroid to reduce inflammation.

Lifestyle and home remedies

Home treatments can be useful for pseudogout flare-ups. Examples include:

  • Nsaids. Over-the-counter Nsaids , such as ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve), are often useful.
  • Rest of the joint. Try not to use the affected joint for a couple of days.
  • Of ice. Cold compresses may help reduce the inflammation associated with breakouts.

Preparing for your appointment

Probably first see your family doctor. After an initial examination, your doctor may refer you to a specialist in the diagnosis and treatment of arthritis and other inflammation of joints (rheumatologist).

Here's some information to help you prepare for your appointment.

What you can do

Before your appointment, you can write a list of answers to the following questions:

  • When did your symptoms begin?
  • Have you had these symptoms before?
  • Does any activity or position, to make your joint feel better or worse?
  • Have you ever injured this joint?
  • Do you have any other medical condition?
  • Has someone in your family has had problems in the joints?
  • What medications or supplements that you take regularly?

What to expect from your doctor

A health care provider who sees you for the common symptoms of pseudogout may ask a series of questions. You can ask:

  • What are your symptoms?
  • What part or parts of your body are affected?
  • Do your symptoms come and go?
  • How long do the symptoms last?
  • The symptoms worsened over time?
  • Is there something that seem to trigger your symptoms, such as injury, overuse of the joint, dehydration, recent surgeries or other diseases?
  • Have you tried any of the treatments? Nothing has helped?
Symptoms and treatment of Pseudogout