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pseudogout

Alternative Names
calcium pyrophosphate deposition disease, CPPD

Definition
Pseudogout is a disease caused by deposits of calcium pyrophosphate crystals in the joints. The crystals cause joint pain and other symptoms. Pseudogout is similar to gout, a disease in which joint pain is caused by deposits of uric acid crystals.

What is going on in the body?
Individuals with this disease have attacks of arthritis. The attacks usually affect the wrist, knee, ankle, and other 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.

What are the signs and symptoms of the disease?
Symptoms of pseudogout include joint pain, joint redness, joint swelling, and chronic arthritis.

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. Occasionally, the cause is hereditary. Pseudogout is most common in the elderly and is more common in males than in females. The risk of pseudogout is increased in individuals who have joint problems from other conditions, such as osteoarthritis.

What can be done to prevent the disease?
There is no known prevention for this disorder.

How is the disease diagnosed?
The diagnosis is made by removing fluid from the joint and looking at the fluid under a microscope to look at the crystals. X-rays of the joints are also taken. These tests and a history and full physical examination will generally give a diagnosis.

What are the long-term effects of the disease?
An individual with pseudogout can suffer from worsening arthritis. However, with good treatment, outcomes are usually excellent.

What are the risks to others?
Pseudogout is not contagious. In some cases, pseudogout may be inherited.

What are the treatments for the disease?
Someone with pseudogout can generally be treated with medication to stop inflammation and reduce pain. Colchicine and non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, are commonly used. Sometimes fluid from the joint is removed to help with pain and swelling.

What are the side effects of the treatments?
Whenever fluid is removed from a joint, there is a risk of introducing bacteria that can cause infection. Pain and bleeding can also result. Non-steroidal anti-inflammatory drugs (NSAIDs) can upset the stomach and cause bleeding. Colchicine is also an irritant to the stomach.

What happens after treatment for the disease?
There can be joint damage if the pseudogout is not treated. Most persons can return to regular activity after the inflammation is treated.

How is the disease monitored?
A person with pseudogout should contact a doctor 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 should also be reported to the doctor.

Author: James Broomfield, MD
Reviewer: HealthAnswers Australia Medical Review Panel
Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia
Last Updated: 1/10/2001
Contributors
Potential conflict of interest information for reviewers available on request


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