Pseudogout

What is Pseudogout?

Pseudogout can cause painful inflammation in your joints due to the accumulation of small calcium crystals. These crystals form in the fluid that lubricates your joints, called synovial fluid, and in the cartilage.

Also called calcium pyrophosphate deposition disease (CPPD), this form of arthritis tends to affect the knees more than other joints, but it can also be found in your wrists, elbows and ankles.

There may be a genetic link for pseudogout; if you have family members with the condition, you’re more likely to have it yourself. Other causes include too much calcium in the blood (hypercalcemia), too much iron, deficiency of magnesium, underactive thyroid or overactive parathyroid gland.

What are the Symptoms of Pseudogout?

If you have pseudogout, you’ll primarily experience joint pain in your knees, ankles, elbows and wrists. The fluid builds up around the joint and you may notice swelling. The condition can become chronic if not treated.

Pseudogout can sometimes have identical symptoms to other forms of arthritis. Your doctor can order tests to determine if pseudogout is the culprit. These tests may include analysis of the joint fluid for calcium pyrophosphate crystals and X-rays to check for signs of calcium buildup around the joints.

Pseudogout Causes

Pseudogout occurs when calcium pyrophosphate dihydrate crystals build up in the tissues and fluid surrounding the joints. This creates inflammation and damage to the joints. It is not fully understood why these crystal deposits occur, but there are several conditions linked with pseudogout which gives us clues as to the cause.

Joint injury or surgery in a joint has been known to lead to pseudogout. People who have gout can also develop pseudogout at the same time. Amyloidosis, which is where abnormal proteins develop in organs and tissues, is also linked with pseudogout.

Pseudogout often occurs in people with abnormal mineral levels, such as:

  • Abnormally high calcium (caused by hyperparathyroidism)
  • Abnormally high iron (hemochromatosis)
  • Abnormally low magnesium (hypomagnesemia)
  • Abnormally low alkaline phosphatase (hypophosphatasia)

However, in many people with pseudogout, no underlying condition or previous injury can be found. In some cases the condition appears to be hereditary, which suggests that some people may simply be more susceptible to it due to their genes.

How is Pseudogout Treated?

One of the primary treatments for pseudogout is over-the-counter anti-inflammatory drugs like ibuprofen. Other nonsteroidal anti-inflammatory drugs that are available by prescription may be needed to treat more severe cases. Corticosteroids may be used on a temporary basis to help reduce inflammation, but the side effects prevent regular use.

Your doctor can also drain the synovial fluid in the joints, which usually alleviates some symptoms. There are no proven methods for removing the crystals that form around the joint, however. In a few cases, complete joint replacement can help sufferers.

Pseudogout Prevention

Since it isn’t clear what causes pseudogout, it’s also not known how to completely prevent it. However, it may be possible to prevent future attacks and reduce the amount of discomfort that pseudogout causes.

A medicine called Colchicine is sometimes prescribed in low doses. Taken daily, it may help to prevent future attacks of pseudogout. It is not suitable for individuals with kidney or liver disease.

Anti-inflammatory medications are also often prescribed for pseudogout, but these may not always be suitable for long term use. NSAIDS (non-steroidal anti-inflammatory drugs) are commonly used, but some individuals are unable to tolerate them. In these cases, corticosteroids may be recommended as they can also help to reduce inflammation. However, steroids leave the immune system compromised, which means that they’re not usually preferred for long term prevention of pseudogout attacks.

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Last Reviewed:
October 10, 2016
Last Updated:
March 30, 2018