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Details:
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 Pseudogout, also know as calcium pyrophosphate
dihydrate crystal deposition disease, (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. The most common joint
effected by CPPD is the great toe joint.
X-ray findings are similar
between gout and CPPD with one exception; individuals with CPPD with show small islands
of calcium deposition in the lining of the joint referred to as
calcinosis. Hence the term chondrocalcinosis is also used
interchangeably pseudogout.
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.
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 controlled by the use of an NSAID.
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Nomenclature:
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No information is available for this topic.
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Anatomy:
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No information is available for this topic.
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Biomechanics:
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No information is available for this topic.
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Symptoms:
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The symptoms of pseudogout are
similar to gout showing an acute onset and significant pain. The location of
pseudogout is typically located in the great toe joint, although other joints
may be involved. X-ray findings
may resemble gout with erosion of the bone adjacent to the joint, called a
Martel's sign. X-rays will only show change in advanced cases where erosion of
the joint has been allowed to progress over an extended period of time.
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Differential Diagnosis:
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The differential diagnosis for this CPPD should include;
Gout
Hallux limitus
Hallux valgus
Metatarsal fracture
Osteoarthritis
Rheumatoid arthritis
Septic arthritis
Sesamoid fracture
Sesamoiditis
Turf toe
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Products Recommended for Pseudogout:
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See Also:
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References:
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This article was written by Jeffrey A. Oster, DPM and last updated
2/8/13. No additional information is available for this condition.
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Calcium pyrophosphate dihydrate deposition disease |
