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Pseudogout is a kind of arthritis marked by sudden, painful, stiffness, redness, warmth, and swelling in one or more joints. Episodes might last a few days or several weeks. Normally, it only affects one joint at a time, but occasionally, it could affect numerous joints at once. It is a condition that frequently impacts the knees and wrists.
CPPD, or calcium pyrophosphate deposition disease, is the medical name for pseudogout. The condition is often referred to as pseudogout due to its resemblance to gout. Crystal deposits develop in a joint in both gout and pseudogout, though the kind of crystals is different in each disease. Some CPPD symptoms may resemble rheumatoid arthritis or osteoarthritis symptoms.
The reason why crystals accumulate in joints and lead to pseudogout is unknown, however the risk rises with age. Inflammation and discomfort can both be reduced by treatments.
Symptoms
The knee or wrist is frequently affected by pseudogout. Less frequently, it might affect the ankles, toes, knuckles, hips, shoulders, and elbows. In rare instances, pseudogout may extend to the neck, resulting in neck discomfort, shoulder pain, headaches, and, in certain cases, fevers.
The affected joints are often swollen, warm, and extremely painful during a pseudogout attack.
If someone has sudden, severe joint pain and swelling, it is advised to seek medical assistance.
Causes
The cause of this condition is the abnormal formation of calcium pyrophosphate dihydrate (CPPD) crystals in the joint fluid (synovial fluid) or cartilage. This may result in an attack of arthritis.
It is frequently unknown what causes abnormal CPPD crystal deposition in cartilage. Some underlying diseases, such as joint injury, hyperparathyroidism, hypomagnesemia, hypophosphatasia, hypothyroidism, and hemochromatosis, can cause CPPD crystals to appear. It’s also possible that the CPPD crystals formation is an inherited characteristic.
As people get older, these crystals occur in over half of the population who are above 85. However, the majority of those with these crystal deposits never have pseudogout. Why some people get symptoms while others do not is still unclear.
Risk factors
The following factors can increase the chance of developing pseudogout:
- Age: Age increases the possibility of developing pseudogout. As people become older, it happens more frequently and typically affects persons over 60. Young patients with CPPD are uncommon.
- Joint trauma: Pseudogout is more likely to occur in a joint after trauma, such as a severe injury or surgery.
- Genetic disorder: Pseudogout is hereditarily more likely to occur in certain families than others. Pseudogout usually appears in these individuals while they are younger.
- Mineral imbalances: People who have too little magnesium or too much calcium or iron in their blood are more likely to develop pseudogout.
- Other medical conditions: Pseudogout has also been connected to both an overactive parathyroid gland and underactive thyroid gland. Degenerative joint disease and osteoarthritis patients frequently experience the problem as well. In some circumstances, CPPD may actually be the cause of “attacks” of osteoarthritis characterized by pain, swelling, and redness of the joint.
Diagnosis
Laboratory test and imaging testing are typically required to establish a diagnosis since pseudogout symptoms might resemble those of gout and other kinds of arthritis.
- Blood test: Blood testing can screen for mineral abnormalities that have been associated to pseudogout as well as thyroid and parathyroid gland issues. It is not possible to diagnose CPPD only from a blood test.
- Imaging test: Joint deterioration and crystal deposits in the cartilage of the joint can frequently be seen on X–rays or CT scan of the affected joint.
- Anthrocentesis: The healthcare provider may take a sample of fluid using a needle in order to examine the fluid in the affected joint for crystals. Joint aspiration (arthrocentesis) is the term for this technique. Removing the fluid can furthermore assist in lowering joint pressure, which could help in easing discomfort.
An appropriate diagnosis must be done since various crystal kinds in the joint can be the root of other types of arthritis. The appropriate treatment can then be recommended by the healthcare provider.
Treatment
While there is no known cure for pseudogout, a combination of treatments can be employed to alleviate pain and enhance joint function. The purpose of treatment is to reduce pain and inflammation while avoiding periodic attacks that can result in severe pain and joint damage.
- Medications: The healthcare provider could advise the following if over–the–counter painkillers are insufficient:
- Colchicine: For CPPD attacks, colchicine is typically administered. This gout medication’s low–dose tablets work well for treating pseudogout as well. The patient can be instructed to take colchicine every day as a preventative precaution if they get pseudogout attacks often.
- Nonsteroidal anti–inflammatory drugs (NSAIDs): NSAIDs consist of indomethacin and naproxen. NSAIDs, especially in elderly persons, might result in gastrointestinal bleeding and impaired renal function. Certain people, such as those with poor renal function, blood problems, stomach or digestive diseases, heart diseases, and certain other health issues, cannot use these medications.
- Corticosteroids: The healthcare provider may advise using corticosteroid medications, such as prednisone, to decrease inflammation and stop the attack if the patient is unable to take NSAIDs or colchicine. Corticosteroid usage for an extended period of time can weaken bones, result in cataracts, diabetes, and weight gain.
- Joint drainage: An injured joint’s pain and pressure can be reduced by draining some of the joint fluid. To remove the fluid, a needle is utilized. The procedure also aids in the removal of certain crystals from the joint. Then a corticosteroid and numbing drug are injected into the joint to reduce pain and swelling.
- Lifestyle and home remedies: In the event of flare–ups of pseudogout, home remedies may be helpful. Examples include the following:
- Nonsteroidal anti–inflammatory drugs (NSAIDs): NSAIDs that are available over–the–counter, such ibuprofen and naproxen sodium, are frequently beneficial.
- Resting the joint: The patient is instructed not to try using the injured joint for a few days.
- Ice compress: Using cold compresses can help lessen the inflammation brought on by flare-ups.
