Medicines for Pseudogout

What it is

Pseudogout is a type of arthritis caused by tiny calcium crystals (calcium pyrophosphate) forming in and around the joints. It gets its name because its attacks can look like gout, but the crystals are different from those in gout (which are urate crystals). It causes sudden episodes of a hot, red, swollen and very painful joint — most commonly the knee, but also the wrist, shoulder, ankle or other joints — which can be triggered by illness, injury or surgery, or occur without an obvious cause. It becomes more common with age and is linked to the build-up of these crystals in the joint cartilage (which can be seen on X-rays). It can also cause a more chronic form resembling other types of arthritis. Because a hot, swollen joint can also be caused by infection (which is serious), a first or uncertain attack is assessed, sometimes by taking a sample of fluid from the joint to look for the crystals and rule out infection.

How it is treated

Treatment of an acute attack aims to settle the pain and inflammation, similar to treating a gout attack: resting the joint, applying ice, and anti-inflammatory medicines or other options depending on the person, and sometimes draining the joint and injecting a steroid, which can quickly relieve a badly affected joint. Attacks usually settle over days to a couple of weeks. Unlike gout, there is no specific treatment to remove the crystals, so management focuses on treating attacks when they occur and, for people with frequent attacks, considering measures to reduce their frequency. Any associated condition that can be linked to calcium crystal build-up may be checked for. Because a hot, swollen joint can signal a joint infection, prompt assessment of a first or severe episode is important to exclude this. With treatment, attacks are manageable, and many people have infrequent episodes.