Pseudogout - 10 Things You Should Know .........From Early Symptoms to Disease Management

Pseudogout is a type of arthritis that is often mistaken for gout or other arthritic conditions. Proper diagnosis of pseudogout is important. Untreated pseudogout can result in severe joint degeneration, chronic inflammation, and chronic disability. Here are 10 facts you should know about pseudogout.

1 - Pseudogout, as its name suggests is similar to gout, but the two conditions are caused by the deposition of different crystals.

Pseudogout is a condition that develops when calcium pyrophosphate crystals accumulate in a joint and the tissues that surround the affected joint. Gout, however, develops when uric acid crystals are deposited in an affected joint.

2 - Pseudogout, also known as CPPD disease, can mimic gout, osteoarthritis, and rheumatoid arthritis.

About 25 percent of people with calcium pyrophosphate dehydrate deposition (CPPD) disease develop what is referred to as pseudogout. About 5 percent of patients develop symptoms that more closely resemble rheumatoid arthritis while approximately 50 percent of patients with CPPD deposition develop symptoms that are like osteoarthritis. Not everyone with CPPD is symptomatic though.

3 - Pseudogout typically develops in one joint and the onset is usually sudden and intense.

A pseudogout attack may be as severe as an acute gout attack but typically it is less painful. Pseudogout attacks:

• usually last anywhere from several days to two weeks
• may be accompanied by fever
• occur spontaneously or can be brought on by severe illness, surgery, or trauma
• cause cartilage and joint damage that worsens after years of attacks

4 - Nearly half of all pseudogout attacks occur in the knee.

While the knee is the most common site for pseudogout, the big toe is most commonly affected by gout. Pseudogout can develop in any joint however, including the big toe.

5 - Anyone can develop pseudogout but the risk increases significantly with age.

The crystal deposits associated with pseudogout affect about 3 percent of people in their 60s. The percentage increases to about 50 percent of people in their 90s. The condition is equally prevalent among women and men.

6 - A small number of people with CPPD crystal deposition disease inherited susceptibility to the condition.

Aside from having a genetic predisposition to pseudogout, the risk of developing the condition is increased if the patient has any of the following metabolic disorders:

• hyperparathyroidism
• hemochromatosis
• hypothyroidism
• amyloidosis
• hypomagnesemia
• hypophosphatasia

7 - The most significant diagnostic test for determining pseudogout is a joint fluid examination.

Joint fluid is drawn from the affected joint and examined for rod-shaped or rhomboid-shaped CPPD crystals. Based on the observation of these crystals the diagnosis can be confirmed. X-ray evidence also supports the diagnosis when chondrocalcinosis (joint cartilage calcified and calcium deposits in joint spaces) is detected. If needed, other lab tests can be performed to rule out other types of arthritis.

8 - There is no cure for pseudogout but there are treatment options for controlling symptoms.

Medications are used to treat symptoms associated with pseudogout. Nonsteroidal anti-inflammatory (NSAIDs) are usually prescribed to control pain and inflammation during pseudogout attacks. For the purpose of preventing further attacks, low doses of colchicine and NSAIDs are typically prescribed. Cortisone shots into the affected joint may be another option for controlling pain and inflammation -- especially for patients who cannot use the other medications. Surgery is also an option for severely damaged joints.

9 - Because pseudogout is considered a misunderstood form of arthritis, it's important to be evaluated by a specialist.

Since pseudogout has characteristics that are similar to other types of arthritis, it's important to be diagnosed by a rheumatologist (a specialist in arthritis and related rheumatic diseases). Early, accurate diagnosis may prevent severe joint damage in some cases.

10 - Diet does not affect the onset or development of pseudogout. A change in diet cannot control symptoms.

Though the crystals associated with pseudogout are partly calcium, it is a myth that eating a lot of foods that contain calcium provoke the development of pseudogout.