Calcium pyrophosphate dihydrate deposition disease; CPPD disease
What is pseudogout?
Pseudogout although similar to gout in that it is an inflammation of the joints, and like gout involves the formation of crystals in the joints is different, pseudogout literally meaning “false” gout.
The main difference is in the crystals formed. In pseudogout is the result of crystals called calcium pyrophosphate, in and around the joints. However, the crystal that incites the inflammation of gout is monosodium urate. Pseudogout has been reported to occasionally coexist with gout. This means that the two types crystals can sometimes be found in the same joint fluid.
What are the symptoms of pseudogout?
Pseudogout can cause arthritis of several joints but commonly is found in the knees, hips, shoulders, , ankles and wrists. Pseudogout usually affects only one or two joints at any given time. Acute joint swelling, stiffness, warmth, and pain commonly signal the onset of such attacks. The attacks may last for days to weeks and can resolve spontaneously.
- Attacks of joint pain and fluid build-up in the joints, leading to joint swelling.
- Chronic (long-term) arthritis.
- No symptoms between attacks
Pseudogout risk factors
Pseudogout mainly affects the elderly. However, it can sometimes affect younger patients who have conditions such as:
Because the symptoms are similar, pseudogout can be misdiagnosed as:
- Gouty arthritis (gout)
- Rheumatoid arthritis
How does a doctor diagnose pseudogout?
Pseudogout is suggested when abnormal calcifications are seen in the cartilage of joints on x-ray testing. These calcifications are referred to as chondrocalcinosis.
The arthritis of pseudogout is more common in older adults, particularly in the context of dehydration.
A diagnosis of pseudogout is made after fluid from a joint is examined under a special microscope (polarizing microscope) and the calcium pyrophosphate crystals are identified.
The treatment of pseudogout is aimed at stopping the inflammation in the joints. Ice applications and resting can help. Non steroidal anti-inflammatory drugs (NSAID) such as ibuprofen are often the first drugs of choice.
Removing fluid containing the crystals from the joint can reduce pain and help the inflammation to diminish more quickly. Cortisone injected into an inflamed joint and oral colchicine are also used.
Long-term prevention of recurrent pseudogout is often best achieved with small daily doses of colchicine.
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