Pseudogout
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.