Pseudogout
Medical Author: William C. Shiel Jr., MD, FACP, FACR
What is pseudogout?
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.
Next: What other conditions can accompany pseudogout? »
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