Pseudogout (often called calcium pyrophosphate deposition disease) is an arthritic condition where calcium crystals form in joints and can cause long-term damage to the joint.

Calcium pyrophosphage dihydrate crystals that deposit in the lining of the joints trigger an immune system reaction. Here, neutrophils are sent to destroy the crystals during which certain enzymes that cause local tissue damage, inflammation, and pain are released.

Signs and Symptoms of Pseudogout

As its name implies, pseudogout is marked by symptoms that are similar to true gout (an arthritic condition caused by deposition of uric acid crystals). These include:

  • sudden joint pain that comes on without warning
  • repeated attacks in one joint
  • swelling or inflammation
  • stiffness and feeling of warmth in the joints

Pseudogout most commonly affects the knees, but can also affect:

  • wrist
  • ankle
  • shoulder
  • elbow
  • hand

A pseudogout attack usually go away by itself, although it can incapacitate someone for days or even weeks. The attack may recur suddenly, affecting another joint (usually one joint at a time).

Cause of Pseudogout

Although the exact cause of pseudogout is unknown, the following are risk factors for developing this condition:

  • hypothyroidism (severely underactive thyroid)
  • hemochromatosis (excess iron storage)
  • overactive parathyroid gland
  • hypercalcemia (excessive level of calcium in the blood)
  • stroke
  • heart attack

Heredity seems to play a role in determining who develops this condition. Many people with pseudogout also have other family members with it.

An attack can be triggered by:

  • stress
  • trauma or injury
  • joint or other surgery
  • severe dieting
  • alcohol abuse

It can also be a result of side effects of thiazide medications (high blood pressure drugs that act as a diuretic by blocking the reabsorption of sodium in the kidney).

Prevalence of Pseudogout

The calcium phosphate dihydrate crystal deposits in pseudogout are found in about 3% of the people in their sixties (however not all experience severe attacks), and this incidence increases with age. Deposits are found in 50% of people in their nineties.

Indeed, the risk of developing pseudogout increases with age.

Pseudogout Diagnosis

To diagnose psudogout, your doctor will use a needle to aspirate or take fluid from the swollen or painful joint to detect the presence of calcium pyrophosphate crystals. X-ray can also be taken to visualize the calcium deposits.

Prevention of Pseudogout

You can help prevent pseudogout by:

  • protecting your joints by avoiding putting undue stress on the joints
  • losing weight or maintaining a healthy weight
  • exercising regularly to maintain strong muscles around the joints

Pseudogout Treatment

Treatments of pseudogout include:

  • Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen to reduce the pain and swelling of the joints.
  • Cortisone hormone or corticosteroids injections into the affected joint
  • Aspiration or removal of fluids from the joint (thereby removing some of the crystals that cause the swelling)
  • Heat or cold compress for temporary relief of pain and swelling.

In severe cases, surgery to remove bits of cartilage, repair the bone, or replace the joint with an artificial joint may be the only option.

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