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Pseudogout

WHAT YOU NEED TO KNOW:

What is pseudogout?

Pseudogout is a type of arthritis. It is also called calcium pyrophosphate deposition (CPPD). Pseudogout most often affects the knees. You may also have symptoms in other large joints, including the hip or shoulder. Pseudogout causes calcium crystals to collect in fluid called synovial fluid that surrounds joints. The crystals damage the cartilage and can cause inflammation and pain.

What increases my risk for pseudogout?

  • Age older than 60 years
  • Joint trauma or surgery
  • A family history of gout or arthritis
  • High blood levels of calcium or iron, or low levels of magnesium or phosphate
  • Dehydration
  • A medical condition such as hypothyroidism, diabetes, or osteoarthritis

What are the signs and symptoms of pseudogout?

  • Sudden, severe pain in one or more joints
  • Swollen, red, warm, painful joints
  • Stiff joints in the morning that loosen as you move around
  • Reduced range of motion in the joint
  • Pain and swelling that lasts up to 2 weeks and that return after periods of no pain or swelling
  • Fever

How is pseudogout diagnosed?

  • A synovial fluid test is used to collect a sample of fluid from around your painful joint. The fluid is sent to a lab to check for calcium crystals. Synovial fluid surrounds and protects your joints.
  • An x-ray, ultrasound, CT, or MRI may show calcium deposits. You may be given contrast liquid to help your joints show up better in the pictures. Tell the healthcare provider if you have ever had an allergic reaction to contrast liquid. Do not enter the MRI room with anything metal. Metal can cause serious injury. Tell the healthcare provider if you have any metal in or on your body.

How is pseudogout treated?

The crystals cannot be removed. The goal of treatment is to reduce pain and swelling, and to maintain joint function.

  • Medicines
    • NSAIDs , such as ibuprofen, help decrease swelling, pain, and fever. This medicine is available with or without a doctor's order. NSAIDs can cause stomach bleeding or kidney problems in certain people. If you take blood thinner medicine, always ask your healthcare provider if NSAIDs are safe for you. Always read the medicine label and follow directions.
    • Steroids reduce inflammation and can help your joint stiffness and pain during gout attacks.
  • Aspiration is a procedure used to drain fluid from around the joint. Your healthcare provider may also inject steroid medicine into the joint after aspiration. Steroids reduce swelling and may relieve pain.
  • Surgery may be used to replace a joint if you develop severe damage to the joint.

How can I manage my symptoms?

  • Rest your painful joint so it can heal. Your healthcare provider may recommend crutches or a walker if the affected joint is in a leg.
  • Apply ice to your joint. Ice decreases pain and swelling. Use an ice pack, or put crushed ice in a plastic bag. Cover the ice pack or bag with a towel before you apply it to your painful joint. Apply ice for 15 to 20 minutes every hour, or as directed.
  • Elevate your joint. Elevation helps reduce swelling and pain. Raise your joint above the level of your heart as often as you can. Prop your painful joint on pillows to keep it above your heart comfortably.
  • Go to physical therapy if directed. A physical therapist can teach you exercises to improve flexibility and range of motion.

When should I seek immediate care?

  • You have severe joint pain that you cannot tolerate.
  • You have a fever or redness that spreads beyond the joint area.

When should I call my doctor?

  • You have new symptoms, such as a rash, after you start treatment.
  • You have questions or concerns about your condition or care.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your healthcare providers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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Associated drugs

Mayo Clinic Reference

Further information

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