Facts About Pseudogout

Pseudogout is clinically similar to gout, except that the attacks of arthritis are caused by deposits of calcium pyrophosphate crystals into the joints/tissues (Berkow, et al., 1997). Thus, this disease is often called calcium pyrophosphate deposition disease (CPDD) (Wikipedia, 2008). Attacks are usually less severe than in gout and may cause chronic pain and stiffness in the joints of the arms and legs, which is often confused with rheumatoid arthritis. Joint damage progresses after years of crystal deposition. The cartilage within the joint may break down, causing pieces of cartilage to float in the joint space. As the cartilage continues to wear away, the bones rub together, resulting in chronic soreness and stiffness in the joints (Arthritis Foundation, 2007).
The cause of pseudogout is unknown. It is perhaps due to high calcium levels, iron levels, or low magnesium levels (Berkow, et al., 1997). This condition sometimes runs in families and some genetic factors are suspected to be contributing factors. These include hypothyroidism, hemochromatosis (excess iron storage), overactive parathyroid glands, and other causes of hypercalcemia (Schumacher, 2006).

The diagnosis of pseudogout is adequately made by taking fluid from an inflamed joint and testing any crystals for calcium pyrophosphate. Calcium pyrophosphate crystals also block x-rays and appear as white crystal deposits on x-rays as opposed to urate crystals which do not appear on x-ray (Berkow, et al., 1997).

Treatment

Pseudogout is more difficult to treat than gout. Reversing any conditions causing excess calcium production in the blood or low magnesium levels may be of benefit (Schumacher, 2006). There is no real longterm treatment. NSAIDs are used to reduce pain. Colchicine is used to reduce inflammation and pain during attacks and may prevent attacks when given orally. Corticosteroids help to reduce inflammation. There is no effective longterm treatment to remove crystals (Berkow, et al., 1997).

It may be possible to end attacks by ingesting large (RDA) doses of magnesium. This is to be taken with vitamin B6 to help absorption (Wikipedia, 2008).

Methotrexate works as an immunosuppressant and a potent antiinflammatory agent has been shown to be an alternative therapeutic option for patients with severe CPDD who fail to respond to conventional therapy with nonsteroidal antiinflammatory drugs and/or glucocorticoids (Chollet-Janin, et al., 2006).

By: vitalethics

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Michael Morales is an EMT-Paramedic and program director for Vital Ethics, providing basic and advanced life support training and certification programs to health care professionals. www.vitalethics.org/ www.vitalethics.org/learninglinks.html

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