Definition of Pseudogout
Pseudogout is a type of crystal-induced arthritis. Pseudogout arthritis is a gout-like arthritis; the pathology, clinical symptomatology and methods of management are similar. However, unlike gout where there is an abnormal elevation of uric acid levels in the blood, Pseudogout arthritis is confined only to the joints and surrounding structures. With circulating uric acid in the blood, there is presence of systemic manifestations in addition to symptoms of arthritis which help distinguish gout from Pseudogout arthritis.
There are two main types of crystal-induced arthritis: gout and Calcium Pyrophosphate Deposition Disease (CPDD). Pseudogout is also referred to as CPDD. In gout, there is deposition of sodium urate crystals in the joint capsule whereas in CPDD, there’s deposition of calcium pyrophosphate crystals.
Causes of Pseudogout
The etiology of Pseudogout arthritis is not well understood. The following factors have been, over the years, consistently linked to Pseudogout arthritis:
- Old age >85 years
- History of trauma to the joint
- Genetic predisposition
- Imbalance in mineral salts e.g. overproduction or decreased excretion
- Hormonal imbalance e.g. underactive thyroid
- Comorbidities e.g. kidney disease
Symptoms of Pseudogout
The symptoms of Pseudogout arthritis are sudden in onset lasting for days and then disappearing. Pseudogout arthritis does not manifest in every person who has accumulated levels of calcium pyrophosphate in the joint. Based on this finding, clinicians and rheumatologists are tempted to conclude that the ‘bouts’ of Pseudogout arthritis ‘Pseudogout attacks’ occur when deposited calcium crystals in the joint squeeze their way through the narrow joint pathways.
The knee and wrist joint are the most common sites of Pseudogout arthritis. It can have symmetric or asymmetric involvement. Involvement of other joints is not uncommon.
- Joint pain is intense and excruciating
- Swelling is noted on the joints
- Increased warmth and redness over the joint area
- Joint stiffness lasting up to 30 minutes.
Treatment of Pseudogout
The main goal of treatment is to relieve pain. Dr. Burke, an orthopedic specialist with a rich background in rheumatology, has achieved great success in treating thousands of patients with Pseudogout arthritis. His treatment plans are specific in targeting pain management as well as disease control to prevent permanent disability. He offers:
- Use of NSAIDs
- Oral steroids and local injections of steroids
- Cold therapy
- Joint immobilization i.e. use of splints
- Minimally-invasive joint manipulation e.g. joint aspiration
- Joint replacement – when it becomes necessary