About Your Diagnosis

Pseudogout is an abrupt and often very painful form of arthritis generally affecting individuals older than 60 years. It usually affects only one joint at a time such as a knee, ankle, wrist, elbow, or shoulder. Because it resembles gout but has a different cause, it is called pseudogout, meaning “false gout.” Pseudogout “attacks” are caused by the release of “crystals,” made of calcium and phosphorus, into a joint. These crystals cause inflammation in the joint, leading to pain and swelling. No one knows why some individuals get pseudogout and others do not. It is not caused by an infection. In other words you cannot “catch” it. The only way to be certain of the diagnosis of pseudogout is to place a needle into the affected joint, remove joint fluid, and look for the pseudogout crystals under a microscope.

Living With Your Diagnosis
Individuals with pseudogout frequently have pain, swelling, warmth, and redness develop rapidly in the affected joint. The pain is often constant and it gets worse if the joint is moved a lot. Everyday activities such as walking, dressing, and lifting may be difficult. In some cases more than one joint may be affected. Some individuals experience fever and fatigue with the arthritis. There is no way to know when or how many attacks an individual will have once they have had their first attack. Attacks may occur at any time; however, certain events such as surgery or an acute illness can trigger attacks. Once the attacks are treated, the symptoms generally resolve within days; untreated they may last for several weeks or more. Between attacks the symptoms resolve completely for most individuals.

Treatment
Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, naproxen, or indomethacin are commonly used to treat pseudogout. Potential side ffects of NSAIDs include stomach upset, ulcers, constipation, diarrhea, headaches, dizziness, difficulty hearing, and skin rash. Occasionally, a more potent anti-inflammatory medicine such as prednisone, a cortisone-like medicine, is necessary. Potential side effects of cortisone-like medicines are increased appetite, weight gain, difficulty sleeping, easy bruising, and stomach upset. Colchicine is another type of anti-inflammatory medication used to treat pseudogout. Colchicine’s potential side effects include stomach cramps, nausea, vomiting, and diarrhea. Removal of the joint fluid from the affected joint followed by a cortisone injection into the joint is another common treatment for pseudogout. Cortisone injections usually provide the most rapid and complete relief of pain and swelling. Aside from the discomfort of the injection, there are very few side effects with cortisone injections. Regardless of the specific treatment used, it is important to rest the affected joint until the symptoms begin to subside.

The DOs
• Rest the affected joint until the symptoms begin to improve.
• Take your medicines as prescribed.
• Ask your doctor which over-the-counter medications you may take with your prescription medications.

The DON’Ts
• Wait to see whether side effects from medications will go away.
• Give up; ask your doctor about other treatment options if your symptoms are not going away on their own.

When to Call Your Doctor
• You experience any medication side effects.
• The treatment is not decreasing your symptoms in a reasonable amount of time.
• You begin to lose full motion in the affected joint.
• You experience worsening warmth, redness, or pain after a cortisone injection.