Causes of Pseudogout
Pseudogout is caused by the collection of calcium pyrophosphate
crystals in joints. There may be attacks of joint swelling and pain in the knees, wrists,
ankles, and other joints.
This condition primarily affects the elderly and usually has no known cause. However,
it can sometimes affect younger patients who have conditions such as acromegaly,
ochronosis, thyroid disease, hemochromatosis, Wilson disease, and parathyroid disease,
which are known to increase risk.
Pseudogout can be initially be misdiagnosed as gouty arthritis, rheumatoid arthritis,
or osteoarthritis because the symptoms are similar to those of these conditions.
Careful workup, with analysis of crystals found in joints, should ultimately lead to
the correct diagnosis. Fortunately, because most conditions involving joint pain are
treated by the same medicines, early misdiagnosis does not necessarily result in
inappropriate treatment. Such treatment often includes steroids and nonsteroidal
anti-inflammatory drugs (NSAIDs),
- Attacks of joint pain and fluid accumulation in the joint, leading to joint swelling
- No symptoms between attacks
- Chronic arthritis
Diagnosis of Pseudogout
- Culture of joint fluid reveals white blood cells and calcium pyrophosphate crystals.
- Joint X-rays may show joint damage, calcification of cartilage, and chondrocalcinosis
(calcium deposits in joint spaces).
Treatment may involve joint aspiration to relieve pressure
within the joint caused by fluid buildup. A needle is placed into the joint and fluid is
Steroid injections may be helpful to treat severely inflamed joints. A course of oral
steroids is sometimes used when multiple joints are inflamed.
Nonsteroidal anti-inflammatory medications (NSAIDS) may help ease the pain of acute
attacks. Colchicine may be useful in some people.