Gout - Pseudogout

Pseudogout

Pseudogout, or CPPD, is a disease very similar to gout. Gout and CPPD are often confused due to their similarities in onset. The cause of CPPD is unknown and seems to effect both men and women equally.

X-ray findings are similar with one exception. Individuals with CPPD with show small islands of calcium deposition in the lining of the joint referred to as calcinosis.

Diagnosing CPPD may only be made by testing a small sample of the synovial fluid from the affected joint. Gout and CPPD can be differentiated by specific testing and identification of the type of crystal.

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Treatment of CPPD

The most significant consideration in the treatment of CPPD is controlling the frequency of attacks. Frequent attacks (more than one a year) will result in progressive erosion of the joint, leading to painful chronic arthritis. Isolated attacks (less that one a year) lead to minimal destruction of the joint. The frequency of CPPD attacks determines whether treatment is merely for each attack, or whether daily medication should be taken to lower levels of inflammation.

Treatment of acute attacks includes the use of non-steroidal anti-inflammatory medications such as Indocin or Clinoril. Control of pain may require a mild narcotic such as codeine. Recurrent attacks may be contolled by the use of an NSAID.

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Symptoms:

The symptoms of pseudogout are similar to gout showing an abrupt onset and significant pain. Xray finding may resemble gout with juxtachondral (immediately next to the joint) erosions of the bone.

Differential Diagnosis:

The differential diagnosis for this condition should include;-

fracture

gout

osteoarthritis

infection of the joint

rheumatic fever

About the author: Jeffrey A. Oster, DPM, C.Ped is a board certified foot and ankle surgeon. Dr. Oster is also board certified in pedorthics. Dr. Oster is medical director of Myfootshop.com and is in active practice in Granville, Ohio.

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