Pseudogout

Pseudogout takes its name from the way that its symptoms closely resemble that of gouty arthritis, or gout, and indeed its pattern of attack can be very similar. It is also caused by the formation of crystals in the joints; however in contrast to gout, the crystals are salt rather than uric acid, with calcium pyrophosphate dehydrate being the salt in question, often referred to as CPPD.
Whilst not specifically affecting the joint of the big toe, it can strike in any joint, although most commonly it is the knees which are the most likely source of crystal formation, and pain. The wrists, ankles, shoulders, elbows and joints of the toes and fingers can also be affected. The condition usually only affects one particular joint at any one time, and the pain can move between quite unrelated joints on each successive attack.
In contrast to gout, pseudogout mostly affects the elderly and is rarely seen in the under 50 age range unless there is a pre-existing condition which makes the development of the condition more likely. The most common causes of pseudogout are hemochromatosis, thyroid dysfunction, kidney disease, diabetes, hypercalcemia and Wilson’s disease. All of these conditions can trigger the onset the condition, as can trauma to the joint.


The painful attacks can onset suddenly, and are unpredictable with no symptoms in between, and in addition to the pain from the formation of crystals, the joints can become arthritic. The condition requires medical diagnosis, with the joint fluid examined for presence of CPPD crystals and white blood cells, to make sure the condition is not confused with gouty and rheumatoid arthritis. An X-Ray is usually taken to assess the degree of arthritic degradation of the joint.
The treatment for pseudogout is primarily pain management and reduction of the inflammation which exists around the joints. In severe cases fluid may be aspirated from the joint to relieve the pressure. Non-steroid anti inflammatory medication is often prescribed, with steroid injections into the joint only called for in the most severe cases. Colchicine is often used to treat patients who cannot take oral NSAID’s drugs or for who steroid injections are not appropriate, and whilst effective at reducing inflammation, swelling and pain this treatment is not without its side effects.

Pseudogout attacks will usually abate within 12 days without treatment, although rapid pain relief is available. The condition has no known cure as such, and the attacks cannot be prevented from occurring aside from treating any condition which can make the development of pseudogout more likely. Treating any underlying condition is the best way to prevent any future painful attacks.
Further information can be found at:
The Arthritis Foundation
arthritis.org/