10 Things You Should Know About Pseudogout

A Condition That Is Often Mistaken for Gout

a woman with a hurt knee
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Pseudogout is a painful joint condition that can develop if you have calcium pyrophosphate dehydrate deposition (CPPD) disease. As it is often mistaken for gout or another rheumatic condition, proper diagnosis is needed. 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. Pseudogout Differs From Gout in the Type of Crystals

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 Mimicks Other Conditions

About 25 percent of people CPPD 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 Suddenly Develops in One Joint

While a pseudogout attack may be as severe as an acute gout attack, typically it is less painful.

A pseudogout attack may have these characteristics:

  • Usually lasts anywhere from several days to two weeks
  • May be accompanied by fever
  • Occurs spontaneously or can be brought on by severe illness, surgery, or trauma
  • Cause s cartilage and joint damage that worsens, following years of attacks

4. Joints Affected

Nearly half of all pseudogout attacks occur in the knee, while the big toe is most commonly affected by gout.

Pseudogout can develop in any joint, though, including the big toe.

5. Who Is at Risk of Pseudogout

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 sixties. The percentage increases to about 50 percent of people in their nineties. The condition is equally prevalent among women and men.  A small number of people with pseudogout have an inherited predisposition to the condition.

The risk of developing the condition is increased if the patient has any of the following metabolic disorders:

6. Diagnosis by a Specialist

Because pseudogout can mimic other types of arthritis, it is important to be evaluated by a rheumatologist—a specialist in arthritis and related rheumatic diseases. An early, accurate diagnosis provides the best chance to prevent severe joint damage.

7. Diagnostic Tests

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. Treatment Options

There is no cure for pseudogout, but medications are used to treat the symptoms. 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. Diet and Pseudogout 

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.

10. Untreated Pseudogout Causes Joint Damage

 If left untreated, pseudogout crystals in the ligaments and cartilage can lead to joint injury. There could then be a loss of normal motion in affected joints. 

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. See your doctor when you experience a sudden painful joint.

Sources:

Barre L. Calcium Pyrophosphate Deposition. (CPPD). American College of Rheumatology.

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

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