Pseudogout (CPPD)

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Harvard Medical School
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Chrome 2001
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Pseudogout (CPPD)
Reviewed by the Faculty of Harvard Medical School

Pseudogout (CPPD)

Diseases and Conditions
9339
pseudogout

What Is It?

Pseudogout is a form of arthritis triggered by deposits of calcium crystals (calcium pyrophosphate dihydrate) in the joints. It is also called calcium pyrophosphate disease (CPPD). This disease can cause short-term or long-term swelling in joints, most often the knee, wrist, shoulder, ankle, or elbow.

As the name suggests, this condition can appear similar to gout, which is caused by another type of crystal -- uric acid crystals -- and commonly causes sudden pain and swelling in a single joint, usually in the foot. Pseudogout also can resemble osteoarthritis or rheumatoid arthritis.

Pseudogout is most common in the elderly. It affects about 3% of people in their 60s and as many as half of people in their 90s. Many people who get pseudogout already have joint damage from other conditions or they may have age-related degenerative joint disease. One theory is that an injury to cartilage allows calcium crystals to be released into the joint space, and these crystals cause inflammation.

In some cases, other medical conditions can make people more likely to develop pseudogout. These include:

  • An underactive thyroid (hypothyroidism)

  • A genetic disorder of iron overload (hemochromatosis)

  • Too much calcium (hypercalcemia) or too little magnesium (hypomagnesemia) in the blood.

Pseudogout also can be triggered by joint injury, such as joint surgery or a sprain, or the stress of a medical illness. Frequently, however, nothing can be identified that might have triggered the disease. Although age-related joint degeneration, prior joint damage or trauma, and these other medical conditions increase the likelihood of an attack of pseudogout, the reason some people develop this condition while others do not is unknown.

Symptoms

 

The most common symptoms are pain, swelling and stiffness around a single joint, especially the knee or wrist. Occasionally, more than one joint is affected at the same time. A low-grade fever may occur during the flare.

Diagnosis

 

Diagnosing pseudogout can be tricky because it can resemble gout, an infection or other causes of joint inflammation. Also, pseudogout  is commonly associated with other joint problems.

X-rays may reveal calcium deposits along the affected joints, although X-rays of many healthy elderly people often show such deposits even when the person has no symptoms of pseudogout. Your doctor may recommend that joint fluid be removed from an inflamed joint. The sample will be tested for the presence of calcium pyrophosphate crystals. The sample may also need to be tested for an infection or other cause of joint inflammation.

Your doctor may want to request tests for conditions that can trigger pseudogout. These may include tests of iron, calcium, magnesium and thyroid function.

Expected Duration

 

Attacks of pseudogout can last for days or weeks. If the condition is not diagnosed, it can cause the joint to degenerate (break down).

Prevention

 

Treatment of a condition that increases the risk of pseudogout (such as hemochromatosis) may prevent development of the disease or repeated attacks. However, when there is no known cause or trigger, there is no way to prevent the development of pseudogout. For people with frequent attacks, taking a nonsteroidal anti-inflammatory drug (NSAID) or colchicine daily may prevent future attacks.

Treatment

 

Fluid can be removed from the joint to ease the pressure. In this procedure, called joint aspiration, a needle is inserted into the joint after the area is numbed, to withdraw fluid. Treatment usually also includes NSAIDs or injections of a medication called a glucocorticoid to keep the swelling down. These two treatments usually eliminate symptoms within hours to a few days.

You may also need to take oral corticosteroids for a short time. Your doctor may prescribe a medicine called colchicine or an NSAID to prevent attacks. A newer medication -- anakinra -- is under investigation as a treatment and prevention for pseudogout. However, it needs to be injected daily and is expensive. So, most likely its use will be limited.

Occasionally, people with recurrent or chronic pseudogout may develop degenerative joint disease. In this case, surgery (such as joint replacement) may become the only effective treatment.

When to Call a Professional

 

If you experience significant joint pain, especially if the joint is swollen, contact your doctor.

Prognosis

 

With treatment, the outlook for pseudogout is usually good. Joint pain and swelling usually go away promptly. It's common for attacks to return, but usually they can be controlled with repeated treatment.

Additional Info

 

American College of Rheumatology
1800 Century Place
Suite 250
Atlanta, GA 30345-4300
Phone: 404-633-3777
Fax: 404-633-1870
http://www.rheumatology.org/

Arthritis Foundation
P.O. Box 7669
Atlanta, GA 30357-0669
Toll-Free: 1-800-283-7800
http://www.arthritis.org/

National Institute of Arthritis and Musculoskeletal and Skin Diseases
Information Clearinghouse
National Insitutes of Health
1 AMS Circle
Bethesda, MD 20892-3675
Phone: 301-495-4484
Toll-Free: 1-877-226-4267
TTY: 301-565-2966
http://www.niams.nih.gov/

Pseudogout (CPPDD)
htmAZCPPD
Pseudogout is a form of arthritis triggered by deposits of calcium crystals (calcium pyrophosphate dehydrate) in the joints. It is also called calcium pyrophosphate deposition disease (CPPDD).
200771
InteliHealth
2011-11-21
t
InteliHealth Medical Content
2013-06-04
9492, 10389, 10580, 25402, 31085,
pseudogout,calcium,arthritis,rheumatology,colchicine,fluid,gout,hemochromatosis,iron,joint inflammation,joint pain,surgery,thyroid
9492
Last updated December 15, 2013


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