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.

Pseudogout Symptoms

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.