PSEUDOGOUT

General Information

DEFINITION--An acute, inflammatory form of arthritis that usually involves the large joints of the body. Pseudogout, like gout, involves deposits of crystals in and around the joints. It is usually characterized by acute attacks, but often the disease may progress without the attacks.

BODY PARTS INVOLVED--Large joints (most often, the knee, wrist, ankle).

SEX OR AGE MOST AFFECTED--Elderly; more common in men than women.

SIGNS & SYMPTOMS

• Acute attacks of swelling and pain in one or more of the joints.
• Joints involved most often are the knee (50% of the time), ankle, wrist and shoulder.
• Attacks may last for two or more days.
• Freedom from pain or less severe pain between attacks.
• Limitation of motion of a joint.
• Fever.

CAUSES--Deposition of crystals formed of calcium pyrophosphate dihydrate (CPPD) in the synovial (joint fluid). Why the crystals form is unknown.

RISK INCREASES WITH

• Trauma.
• Aging.
• Patients hospitalized for other medical or surgical illnesses.
• Metabolic diseases (e.g., hypothyroidism, hyperthyroidism, gout, amyloidosis).

HOW TO PREVENT

• None known to prevent original disorder.
• Attacks may be triggered by stress, trauma, surgery, severe dieting, thiazide therapy and alcohol abuse. Avoid any of these when possible.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor.
• Diagnosis is made by microscopic examination of a sample of joint fluid. This will distinguish it from gout, which is caused by different urate crystals.

APPROPRIATE HEALTH CARE

• Doctor's treatment.
• If appropriate, treatment for any underlying metabolic disorder.
• Drainage of the inflamed joint if needed.

POSSIBLE COMPLICATIONS

• Recurrences of the attacks.
• Permanent joint damage.

PROBABLE OUTCOME--Prognosis for relief in acute attacks is excellent.

How To Treat

GENERAL MEASURES----Moist, warm compresses applied to affected joint may be helpful.

MEDICATION--Your doctor may prescribe:

• Nonsteroidal anti-inflammatory drugs to promptly control acute attacks.
• Intravenous colchicine for persistent pain (rarely needed). Oral colchicine may help prevent acute attacks. Ask your doctor.
• Corticosteroid injection into the joint to help relieve symptoms.

ACTIVITY--

• Avoid putting weight on affected joint during acute attack.
• Once pain subsides, begin range of motion exercises or isometric exercises to maintain strength.

DIET--No special diet.

Call Your Doctor If

• You have signs or symptoms of pseudogout.
• Symptoms worsen after treatment begins.
• New or unexplained symptoms develop. Drugs used in treatment may cause side effects.
• Temperature goes over 101F (38.3C).