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Pseudogout

Details:

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.

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.


Nomenclature:

No information is available for this topic.


Anatomy:

No information is available for this topic.


Biomechanics:

No information is available for this topic.


Symptoms:

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.


Differential Diagnosis:

Fracture

Gout

Hallux limitus

Hallux valgus

Osteoarthritis

Rheumatoid arthritis

Septic arthritis

Sesamoiditis


Products Recommended for Pseudogout:

See Also:

References:

This article was written by Jeffrey A. Oster, DPM and last updated 6/13/07.  No additional information is available for this condition.


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