Definition, symptoms, treatment, etc.

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Pseudogout is the term some people use for calcium pyrophosphate deposition disease (CPPD), which occurs when calcium pyrophosphate crystals form and accumulate in the joints and surrounding tissues. CPPD is a type of arthritis that has symptoms similar to gout.

Gout is also a type of arthritis, but its symptoms result from the buildup of another type of crystal. Healthcare professionals may need to check which crystals are present to distinguish between gout and pseudogout.

There is no cure for CPPD, but treatments are available and a person can take measures at home to manage the condition as well.

This article explains what CPPD is and how it differs from gout. It also examines the symptoms, causes, risk factors, and treatment options.

CPPD is a type of arthritis that is painful and starts suddenly.

It occurs when calcium pyrophosphate crystals build up in the joints and the tissues around them. This build-up causes symptoms that can resemble gout. However, the drop results from a different type of crystal.

The Arthritis Foundation (AF) states that a person is more likely to develop PDPD as they age. Almost half of people over 85 have developed the crystals. However, many people do not have any symptoms.

Without treatment, a person can experience painful and severe attacks or chronic inflammation and pain. Over time, CPPD can lead to joint damage and long-term disability.

Although no treatment is available to dissolve the crystals, a person can take medication to help manage the symptoms.

Symptoms of CPPD can come on suddenly and last for days or weeks. They can also come and go.

Although it typically affects the knees, CPPD can affect other joints as well, including:

  • cuffs
  • hands
  • elbows
  • ankles
  • shoulders

A person may experience episodes of symptoms that include:

  • swelling
  • articular pain
  • stiffness
  • fever

The affected joint may also feel hot to the touch.

Over time, CPPD can lead to long-lasting inflammation and joint damage. These symptoms can resemble those of rheumatoid arthritis and osteoarthritis, and they can be present at any time.

If the disease becomes chronic, symptoms may include:

  • articular pain
  • stiffness
  • inflammation
  • decreased joint function
  • stiffness and fatigue upon awakening
  • swelling in the joint

Healthcare professionals do not know the exact cause of CPPD.

However, a person is more likely to develop CPPD as they age. The American College of Rheumatology notes that CPPD affects 3% of people in their 60s and 50% of those in their 90s.

Although it can occur at any age, the American Society for Surgery of the Hand (ASSH) states that CPPD occurs most often in men over the age of 60.

CPPD occurs more often in those who have:

  • a family member with CPPD
  • a thyroid disorder
  • renal failure
  • a calcium disorder
  • an iron metabolism disorder

The disease can also develop in the joints as a result of injury or surgery.

There is no cure for CPPD. Researchers have yet to find a way to get rid of the crystals that cause the disease.

Instead, people can work with healthcare professionals to reduce the frequency of attacks and relieve symptoms.

If an attack does occur, ASSH suggests people try the following for symptom relief:

People who have poor kidney function, take blood thinners, or have a history of stomach ulcers cannot take NSAIDs. In these cases, the healthcare professional may drain the joint fluid and inject a corticosteroid.

Additionally, AF notes that certain foods can help fight inflammation. People can try to include many of the following foods in their diet:

  • Fruit: Good options include cherries, strawberries, raspberries, and citrus fruits.
  • Fish: People can try to eat salmon, herring, tuna, sardines, scallops and anchovies.
  • Nuts: AF particularly recommends walnuts, pine nuts, almonds and pistachios.
  • Beans: Kidney beans and pinto beans are particularly rich in antioxidants.
  • Olive oil: People should aim for 2-3 tablespoons per day.
  • Whole grains: These include oatmeal, brown rice, and quinoa.
  • Nightshade vegetables: Examples include eggplants, potatoes, tomatoes, and red peppers. Some people believe that these foods trigger arthritis flare-ups, so it’s best to watch for symptoms when you eat them.

People should avoid processed foods and those high in saturated fat.

Doctors may prescribe anti-inflammatory drugs to relieve pain and swelling. Sometimes they may also recommend corticosteroid injections or low doses of colchicine to help prevent future attacks.

A variety of medical treatments are available for people with more severe CPPD, and they work by reducing the swelling that causes the symptoms. These treatments include:

  • hydroxychloroquine
  • methotrexate
  • anakinra

If none of these drugs work, a person may need to have surgery to repair or replace the damaged joint or joints.

The AF notes that although gout and CPPD are two types of arthritis, they have different causes.

Gout occurs when high levels of uric acid cause monosodium urate crystals to form in and around the joint. This causes inflammation and damage to the joints. CPPD occurs when calcium pyrophosphate crystals form and accumulate in the joints and surrounding tissues, causing pain and inflammation.

In some cases, a healthcare professional may need to examine the crystals under a microscope to make a correct diagnosis, as symptoms may be similar.

Both conditions begin with the sudden onset of painful, swollen, and hot joints. However, gout usually affects only one joint initially. It tends to be the big toe, but gout can also affect:

  • foot
  • peg
  • wrist
  • knee
  • elbow
  • finger

CPPD can affect one or more joints, but symptoms are more common in the knee.

In some cases, CPPD can affect the spinal ligaments, which can cause pain, usually in the cervical or chest spine.

The American College of Rheumatology claims that CPPD is difficult to diagnose because it closely resembles gout and other types of arthritis.

If the doctor suspects that the person has pseudogout, he or she:

  • asking about symptoms, such as when they started and how long they last
  • ask questions about the person’s family and medical history
  • image the joint using x-rays or ultrasounds, computed tomography or MRI

They can also use a needle to draw a small amount of fluid from the affected joint and send it to a lab. Technicians will check for the presence of calcium pyrophosphate crystals.

There is no cure for CPPD, but people can manage the condition using medication and lifestyle adjustments.

However, over time, calcium pyrophosphate crystals can further damage the joint. In some cases, this damage can result in disability.

Anyone who suspects they have CPPD should see a doctor as soon as possible.

The doctor can diagnose or rule out CPPD and help set up a treatment plan if necessary. Left untreated, the disease can cause long-term damage.

Pseudogout is a condition that the medical community generally refers to as CPPD. It is a type of arthritis that occurs when calcium pyrophosphate crystals build up in the joints and surrounding tissues.

Doctors don’t know what causes CPPD. However, it usually develops with age. In some cases, a person can develop crystals but not have any symptoms.

If symptoms appear, a person may experience swelling, pain, and stiffness in the affected joint or joints, which will also be warm to the touch.

There is no cure for CPPD, but a person can take medication to help relieve symptoms and prevent future attacks. If an attack occurs, they should rest the affected joint, apply ice packs, and take pain relievers.

Anyone who suspects they may have CPPD should talk to a doctor. Left untreated, the disease can cause long-term damage to the joints.


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