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News Letter

Pseudogout: Learn the Causes, Symptoms and Treatments Print E-mail

Introduction

On the surface, pseudogout is similar to other forms of arthritis such as gout, rheumatoid arthritis and osteoarthritis. However, pseudogout's cause is not so well understood and it has some unique characteristics which affect how it is managed.

Cause

Pseudogout is thought to be related to abnormal thyroid or parathyroid gland function. It is also considered to be a disease that people inherit.

Pseudogout results from the abnormal formation of calcium pyrophosphate (CPP) crystals in the cartilage of joints. CPP crystals may then be deposited into the joint fluid (synovial fluid) causing sudden inflammation and pain in the joint. This is a reaction similar to gout where uric acid crystals build up in the joints. Pseudogout's crystals can often be seen by a physician on X-Rays and found by microscopic examination of joint fluid samples.

Over time, calcium crystals can also get into the cartilage causing symptoms similar to osteoarthritis. The type of problem pseudogout causes depends on which joints are involved and where in the joint the calcium crystals are deposited.

Symptoms

When pseudogout attacks, it usually affects the knee, the ankle, the wrist or a combination of these joints. The inflammatory reaction makes the involved joints red, hot, swollen and painful.

Pseudogout symptoms can be mistaken for rheumatoid arthritis or an infection. After many attacks, the joint surfaces become calcified and eventually stiffen to the point that normal joint motion is lost. Sitting, standing, walking or other daily activities may become difficult.

Treatment

The strength of the treatment for acute or chronic pseudogout should match the severity of the inflammatory reaction and its symptoms. Various degrees of swelling, redness, pain and stiffness are managed by a combination of medicines, rest, injections, splints or applying ice or heat to the involved joints.

A swollen joint can be injected with corticosteroid anti-inflammatory medications often referred to as a cortisone shot. Non-steroidal anti-inflammatories (NSAIDs) can be taken. Stronger steroidal anti-inflammatory drugs are sometimes given when multiple joints are affected. Calcium pyrophosphate crystals can be removed directly from the joint fluid by draining or aspirating the joint.

In severe cases, if the disease process has physically destroyed the joint, surgery such as a total joint replacement may be needed to relieve the pain and restore movement to the joint.

Physical and occupational therapy may be prescribed to try and maintain or improve joint movement. Certain medications, such as colchisine, are given to help prevent the onset of pseudogout attacks and to rapidly provide relief for acute attacks. Minimizing the damage caused by pseudogout is a goal of treatment and it's done by preventing or minimizing attacks.

 

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