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Apparently, gout has a twin sister named pseudogout. While gout and pseudogout may share the same characteristics and symptoms, they are caused by different types of crystals that settle in the joints, leading to pain and swelling.
Pseudogout is another type of inflammatory arthritis marked by sudden pain, swelling, and inflammation of the joints. These painful events can last for days or weeks. Pseudogout commonly presents in older adults and most usually affects the knees.
Pseudogout has a rapid onset of pain, caused by calcium pyrophosphate crystals, and usually affects the large joints of the arms and legs.
Symptoms:
Pseudogout usually attacks the knee joints, as well as the ankles, hands, wrists, elbows and shoulders. Symptoms of pseudogout include:
Edema (swelling) of the joints, inflammation, warmth, severe joint pain
Causes of Pseudogout:
Calcium pyrophosphate dihydrate (CPPD) forms in the joint's cartilage, then crystalizes and accumulates in the lining, or synovium of the joint, resulting in the pain, swelling, and inflammation.
Approximately one half of elderly people 90 and over have CPPD crystals present in their joints, but remain asymptomatic.
Pseudogout is also known as calcium pyrophosphate deposition disease, which can lead to calcification and destruction of joint cartilage.
Risks include:
- Family members with pseudogout.
- Hypothyroidism an underactive thyroid.
- Hemochromatosis excess iron storage.
- Overactive parathyroid gland.
- Hypercalcemia (elevated calcium in the blood).
- Kidney failure.
- Diabetes.
- Recent surgery.
- Joint injury.
Diagnostic testing:
Pseudogout can often be misdiagnosed as gout, as well as osteoarthritis or rheumatoid arthritis. That is why testing is important to distinguish between gout, pseudogout, and other arthritic conditions.
Tests for pseudogout include:
Aspiration needle biopsy of synovial fluid
X-rays: X-rays of your knee can reveal other conditions caused by CPPD crystals, such as crystal deposits in the joint cartilage (chondrocalcinosis) and joint damage.
Your doctor will determine the cause of joint pain and inflammation, such as infection, gout, injury, and rheumatoid arthritis.
Complications:
The CPPD crystal deposits can result in damage to the joint structure. Damage can be caused by:
Cysts, fractures, bone spurs and cartilage loss.
Treatment:
Treatment focuses on reduction of pain and swelling. However, treatment does not eliminate the CPPD crystals from the joints.
Treatment involves:
Anti-inflammatory medications, such as aspirin to reduce inflammation.
Nonsteroidal anti-inflammatory drugs (NSAIDs): Such as ibuprofen (Advil, Motrin, others), naproxen (Aleve) and indomethacin (Indocin). Side effects can include stomach bleeding and kidney damage.
Colchicine: Decreases inflammation in people with gout, but can be used in the management of pseudogout when NSAIDs is contraindicated. Side effects include stomach pain, nausea, diarrhea and vomiting, and bleeding.
Joint aspiration and injection: For relief of pain and pressure in the joint, by removing some of the fluid present in the affected joint. An injection of corticosteroids reduces inflammation and an anesthetic to temporarily numb your joint.
Low doses of colchicine are effective in preventing future attacks of pseudogout, as future attacks will always be a possibility. Preventing them will have better success by following your doctor's orders and taking your medications as prescribed to prevent complications and avoid future attacks.
