Pseudogout or Real Gout
"The Attack Lasted Several Weeks"
Marcy Hampton* is retired and enjoys auditing classes at her local
community college, but one day, as she sat in psych 101 she had a terrible pain
in her knee. "I barely made it to my car. The attack lasted several weeks
and it was a great hindrance to getting around. My knee felt tight and it
burned. In fact, my knee hurts pretty often."
Marcy's experience mirrors that of other pseudogout sufferers. Unlike
gout, which often attacks the big toe, pseudogout tends to affect large joints
such as the knee. Common joints in which pseudogout appears other than the knee
are: shoulder, ankle, elbows, hands, and wrists.
In gout, crystals that form under the skin, known as tophi, can
sometimes be dissolved, but the crystals formed by pseudogout have a different
chemical makeup and cannot be dissolved. Still, treatments exist which can help
relieve the pain and inflammation of pseudogout which is characterized by
swelling of the affected joint, a feeling of warmth, and severe joint pain.
Some pseudogout sufferers, like Marcy Hampton, experience recurrent attacks.
While gout is caused by a buildup of uric acid crystals, pseudogout is
caused by a buildup of calcium pyrophosphate dihydrate (CPPD) in the lining of
the joint. No one really understands why the chemical builds up or how it
migrates to the lining of the joint, the synovium. It is known that while half
of the over-90 crowd has these crystals, most of them do not experience
pseudogout symptoms. Pseudogout is really a common term for a disease called
calcium pyrophosphate deposition disease and pseudogout is only one of the
symptoms associated with the disease which can cause a calcification of the joint
cartilage known as chondrocalcinosis as well as a degeneration of the large
joints. It's important to note that not every pseudogout sufferer experiences
all of these associated conditions.
There are several risk factors that can predispose you to pseudogout, such as
age, trauma to the joints, certain genetic disorders, and an excess of iron
stores in the body known as hemochromatosis.
Screening tests exist to help determine whether a sufferer has gout or
pseudogout and the distinction is important in making sure you receive the
treatment that fits your condition. Your doctor will want to analyze your joint
fluid and x-ray the affected joint. He will also want to rule out other
conditions, such as infection, that can mimic pseudogout or gout, such as
osteoarthritis and rheumatoid arthritis.