Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Pseudogout is a type of inflammation of joints (arthritis)
that is caused by deposits of crystals, called calcium pyrophosphate, in and around the joints. Pseudogout literally means "false gout."
Pseudogout has many similarities to true gout, which also can cause
arthritis. However, the crystal that incites the inflammation of gout is monosodium urate. The crystals that cause pseudogout and gout each have distinct appearances when joint fluid containing them is viewed under a microscope. This makes it possible to precisely identify the cause of the joint inflammation when joint fluid is available.
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. Researchers have also noted that the cartilage of patients who had both forms of crystals in their joint fluid was often visibly calcified, as seen on x-ray images.
What are symptoms of pseudogout?
Pseudogout can result in arthritis of a number of joints but
commonly
involves the knees, wrists, shoulders, hips, and/or ankles. Pseudogout
usually
affects only one or a few joints at a time. The
"attacks" of
joint inflammation, characterized by acute joint swelling, warmth, stiffness, and pain, may last for days to weeks and can resolve
spontaneously.
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 common in older adults, particularly in the
context of dehydration such as occurs with hospitalization or surgery.
The diagnosis of pseudogout is ultimately made when fluid from
a joint
is examined under a special microscope called a polarizing
microscope. With
this microscope, the calcium pyrophosphate crystals are
identified.
What are treatments for pseudogout?
The treatment of pseudogout is
directed toward stopping the inflammation in the joints. Local ice applications
and resting can help. Nonsteroidal antiinflammatory drugs (NSAIDs) such as ibuprofen and others
are often
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.
Gout is a condition that results from crystals of uric acid depositing in tissues of the body. Gout is a condition that can lead to abnormally elevated levels of uric acid in the
blood, recurring attacks of joint inflammation (arthritis), deposits of
hard lumps of uric acid in and around the joints, and decreased kidney
function and kidney stones.
The knee joint is composed of three compartments and ligaments which stabilize the joint. Causes of knee pain may include injury, degeneration, infrequently infection and rarely bone tumors. Although routine x-rays do not revel meniscus tears, they can be used to exclude other problems of the bones and tissues. The knee joint is the most commonly involved joint in rheumatic disease, as well as immune diseases that affect various tissues of the body.
Bursitis of the hip results when the fluid-filled sac (bursa) near the hip becomes inflamed due to localized soft tissue trauma or strain. Symptoms include stiffness and pain around the hip joint. If the hip bursa is not infected, hip bursitis can be treated with ice compresses, rest, and antiinflammatory and pain medications.
Arthritis is inflammation of one or more joints. When joints are inflamed they can develop stiffness, warmth, swelling, redness and pain. There are over 100 types of
arthritis including osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, lupus, gout,
and pseudogout.
Bursitis of the knee results when any of the three fluid-filled sacs (bursae) become inflamed due to injury or strain. Symptoms include pain, swelling, warmth, tenderness, and redness. Treatment of knee bursitis depends on whether infection is involved. If the knee bursa is not infected, knee bursitis may be treated with ice compresses, rest, and antiinflammatory and pain medications.
Hereditary hemochromatosis (iron overload) is an inherited disorder in which there is excessive accumulation of iron in the body. Individuals may have no symptoms or signs, or they can have severe symptoms and signs of iron overload. The most effective treatment for hemochromatosis is therapeutic phlebotomy.
Hydroxyapatite crystal disease is the inflammation caused by hydroxyapatite crystals. These tiny crystals of hydroxyapatite deposit by mistake in or around joints and may cause inflammation of the joints and nearby tissues such as the tendons and ligaments (particularly causing rotator cuff problems in the shoulder). Treatment options include rest, cold application, medications to reduce inflammation, and cortisone-related medication injections.
Arthritis is a joint disorder featuring inflammation. A joint is an area of the body where
two different bones meet. A joint functions to move the body parts connected by its bones.
Arthritis literally means inflammation of one or more joints.
Arthritis is frequently accompanied by joint pain. Joint pain is
referred to as arthralgia.
There are many types of arthritis (over 100 identified, and the number is growing). The types range from those related to wear and tear of cartilage (such as osteoarthritis) to those associated with inflammation resulting from an overactive immune system (such as rheumatoid arthritis). Together, the many types of arthritis make up the most common chronic illness in the United States.
The causes of arthritis depend on the form of arthritis. Causes include injury (leading to osteoarthritis), metabolic abnormalities (such as gout and pseudogout), hereditary facto...
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