Pseudogout - 10 Things You Should Know

A Condition That Is Often Mistaken for Gout

157742382.jpg
Todor Tcvetkov/E+/Getty Images

Pseudogout is often mistaken for gout or another rheumatic condition. 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 and understand about pseudogout.

1 - As its name suggests, pseudogout 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 develops when uric acid crystals are deposited in the affected joint.

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

About 25 percent of people with calcium pyrophosphate dehydrate deposition (CPPD) disease develop what is commonly 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. However, not everyone with CPPD is symptomatic.

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

While a pseudogout attack may be as severe as an acute gout attack, 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, following 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, though, 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 pseudogout have an inherited predisposition 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:

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 is detected. If needed, more 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 people who cannot use the other medications. Surgery is also an option for severely damaged joints.

9 - Because pseudogout can mimic other types of arthritis, it is 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).

An early, accurate diagnosis provides the best chance to prevent severe joint damage.

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 consuming foods high in calcium provokes the development of pseudogout.

A Word From Verywell

Proper treatment depends on a proper diagnosis. While that can be said of any disease or condition, it is especially true when there are overlapping symptoms or when one condition mimics another. If left untreated, there can be consequences. Pseudogout crystals in the ligaments and cartilage can lead to joint injury. There could then be loss of normal motion in affected joints. As always, take your symptoms to your doctor.

Sources:

Barre, Luke, MD. Calcium Pyrophosphate Deposition. (CPPD). American College of Rheumatology. Updated March 2017.

Calcium Pyrophosphate Dihydrate Crystal Deposition Disease (CPPD). Arthritis Foundation.

Gout and Pseudogout. American Society for Surgery of the Hand.

Continue Reading