MEDICAL CONDITIONS
Pseudogout
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. These two crystals have distinct appearances when joint fluid containing them is viewed under a microscope, making it possible to precisely identify the cause of the joint inflammation. Pseudogout was recently reported by scientists to coexist with gout more commonly than expected. 5.5% of patients with gout also had crystals of pseudogout. This means that the two crystal-induced forms of arthritis can coexist. Although this coexistence had been previously reported, this high rate is somewhat surprising. The researchers 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. 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, oral and intravenous colchicine are also used.
Long-term prevention of recurrent pseudogout is often best achieved with small daily doses of colchicine.
What other conditions can accompany pseudogout?
Pseudogout can occur along with aging, be inherited, or be associated with hemophilia, ochronosis, amyloidosis , or hormonal disorders (such as hyperparathyroidism and hypothyroidism ). These illnesses are considered in the initial evaluation of a patient with pseudogout.
Are there special circumstances that can promote attacks of pseudogout?
Arthritis attacks of pseudogout can be precipitated by dehydration and not infrequently follow surgical procedures in elderly patients. Patients with known pseudogout should stay well hydrated before and after operations.
Pseudogout At A Glance - Pseudogout is caused by crystals in a joint.
- Pseudogout causes arthritis (joint inflammation).
- Pseudogout can cause calcification of cartilage.
- The arthritis of pseudogout is diagnosed by detecting typical crystals in joint fluid.
- Treatment of pseudogout is directed at the inflammation.
- Pseudogout can be associated with other illnesses.
Author: William C. Shiel Jr., MD, FACP, FACR
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