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Pseudogout

Alternate Names

  • calcium pyrophosphate deposition disease
  • CPPD

Definition

Pseudogout is a form of arthritis, or joint inflammation, that is caused by deposits of calcium pyrophosphate crystals in the joints. The crystals cause joint pain and other symptoms. Pseudogout is similar to gout, another form of arthritis in which joint pain is caused by deposits of uric acid crystals.

What is going on in the body?

The joint inflammation of pseudogout is caused by calcium pyrophosphate crystals deposited in the joints. Pseudogout may resemble gout in many ways. The main difference between gout and pseudogout is that the joint crystals are different. In pseudogout, calcium pyrophosphate crystals collect in the joints. In gout, the crystals are uric acid crystals. The crystals in the joint cause similar inflammation and symptoms in both conditions.

Risks

What are the causes and risks of the disease?

Pseudogout is caused by the deposit of calcium pyrophosphate crystals in the joints. Why the deposits occur is usually not known, but most cases are likely related to an overproduction of pyrophosphate.. Occasionally, the cause is hereditary.
Pseudogout is most common in elderly individuals and is more common in males than in females. People with hormonal disorders involving the thyroid or parathyroid glands are also more likely to develop pseudogout.

Prevention

What can be done to prevent the disease?

There is no known prevention for pseudogout.

Diagnosed

How is the disease diagnosed?

The diagnosis of pseudogout starts with a medical history and physical examination. Then the healthcare provider may do a joint aspiration, inserting a needle into the joint space to remove some of the joint fluid. The fluid is examined in the laboratory for the presence of calcium pyrophosphate crystals. Joint X-rays might be used to look for crystals in the joint.

Long Term Effects

What are the long-term effects of the disease?

An individual with pseudogout can suffer from worsening arthritis and permanent disability although most persons will retain good function.

Other Risks

What are the risks to others?

Pseudogout is not contagious and poses no risk to others.

Treatments

What are the treatments for the disease?

Pseudogout is treated with medications to stop inflammation and reduce pain. Colchicine and nonsteroidal anti-inflammatory drugs, or NSAIDs such as ibuprofen (i.e., Advil, Motrin) or naproxen (i.e., Aleve, Naprsyn), are commonly used. Corticosteroids (i.e., Prednisone, Dexamethasone) may be given as pills or injected into the affected joint. Sometimes fluid is removed from the joint to help control joint pain and swelling.

Side Effects

What are the side effects of the treatments?

Any time fluid is removed from or injected into a joint, there is a slight risk of introducing bacteria that can cause infection. Pain and bleeding can also result. Colchicine, nonsteroidal anti-inflammatory drugs, or NSAIDs, and corticosteroids may cause nausea, vomiting, diarrhea, abdominal distress, and allergic reactions.

After Treatment

What happens after treatment for the disease?

Treatment of pseudogout may be lifelong, because the disease flares up periodically. Most people can return to regular activity after the acute attacks subside.

Monitor

How is the disease monitored?

A person with pseudogout should contact a healthcare provider if there is an increase in joint pain or swelling. This may indicate an acute attack that can be treated with medications. Any other new or worsening symptoms also should be reported to the healthcare provider.

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