Overview

Definition:
Pseudogout is a joint disease that may include intermittent attacks of arthritis.

Alternative Names:
Calcium pyrophosphate deposition disease; CPPD

Signs and tests:
Culture of joint fluid reveals white blood cells and calcium pyrophosphate crystals.
Joint X-rays may show joint damage, calcification of cartilage, and chondrocalcinosis (calcium deposits in joint spaces).

Pseudogout Information

Causes, incidence, and risk factors:
Pseudogout is caused by the collection of calcium pyrophosphate crystals in joints. There may be attacks of joint swelling and pain in the knees, wrists, ankles, and other joints.
This condition primarily affects the elderly and usually has no known cause. However, it can sometimes affect younger patients who have conditions such as acromegaly, ochronosis, thyroid disease, hemochromatosis, Wilson disease, and parathyroid disease, which are known to increase risk.
Pseudogout can be initially be misdiagnosed as gouty arthritis, rheumatoid arthritis, or osteoarthritis because the symptoms are similar to those of these conditions.
Careful workup, with analysis of crystals found in joints, should ultimately lead to the correct diagnosis. Fortunately, because most conditions involving joint pain are treated by the same medicines, early misdiagnosis does not necessarily result in inappropriate treatment. Such treatment often includes steroids and nonsteroidal anti-inflammatory drugs (NSAIDs).

What Can People With Gout Do To Stay Healthy?

To help prevent future attacks, take the gout medications that your doctor prescribes. Carefully follow instructions about how much medicine to take and when to take it. Acute gout is best treated when symptoms first occur.
Tell your doctor about all the medicines, dietary supplements, and vitamins you take. He or she can tell you if any of them increase your risk of hyperuricemia.
Plan followup visits with your doctor to evaluate your progress.
Exercise regularly and maintain a healthy body weight. Lose weight if you are overweight, but do not go on diets designed for quick or extreme loss of weight because they increase uric acid levels in the blood.

Gout's surprising prevalence

Gout is actually a disease with a long history. Benjamin Franklin reportedly suffered terribly from gouty arthritis. According to the Arthritis Foundation, approximately 2.1 million Americans are affected by gout. Though it can affect anyone at any age, gout typically affects men between 40 and 50 years old. Gout is nine times more common in men than women. As for women who have gout, the painful condition usually develops after menopause.

TREATMENT

Treatment of Gout:
Treatment of gout involves medications and lifestyle modifications. Medications include:
NSAIDs (nonsteroidal anti-inflammatory drugs) - used to decrease pain and inflammation
Corticosteroids - for people who cannot take NSAIDs
Probenecid and sulfinpyrazone - help kidneys eliminate uric acid (sulfinpyrazone is not currently available in the U.S.)
Allopurinol - blocks production of uric acid
Colchicine - for acute gout attacks or as a prophylactic
Lifestyle modifications are important; they include weight management, abstaining from alcohol, and avoiding meats, seafood and other foods high in purines.

A painful form of arthritis

Gout is considered one of the most intensely painful types of arthritis. Gout is characterized by sudden onset of severe pain, tenderness, warmth, redness, and swelling from inflammation of the affected joint. Gout usually affects a single joint and most often the big toe is affected (i.e. podagra). The knee, ankle, foot, hand, wrist, and elbow may also be affected. Shoulders, hips, and spine may eventually be affected by gout, but rarely. Other conditions which mimic gout include:
pseudogout
psoriatic arthritis
rheumatoid arthritis
infection

Gout overview

Causes of Gout:
Gout develops from an accumulation of excess uric acid in the body which causes uric acid crystals to deposit in the joints. Excess uric acid can result from increased uric acid production or decreased elimination of uric acid from the body. Certain purine-rich foods can cause an increase in uric acid levels. Some medications also can cause increased uric acid levels.
Symptoms Associated With Gout:
During an acute episode of gout, the patient may be startled by the suddenness and severity of joint pain and swelling. Often the first gout attack occurs at night. Observation of the foot may reveal red or purple shiny skin around the joint. Typically the gout attack goes away after 5-10 days. Without treatment, gout attacks may occur with more frequency and may last longer. Frequent gout attacks can damage the affected joint.

Diagnosis of Gout:
Proper diagnosis is important. Diagnosis is based on physical findings and diagnostic tests including the identification of characteristic crystals. Fluid is extracted from the affected joint and a microscopic examination revealing monosodium urate crystals would be consistent with the diagnosis of gout. Crystals known as tophi may also be found in deposits under the skin. Blood uric acid levels are less useful or definitive. The blood uric acid level can be normal or low during an attack or can be elevated in people who have never had a gout attack.

Points of Interest About Gout:

Points of Interest About Gout:

Gout was once referred to as "the disease of kings" because it was thought to be rooted in overindulgence in the food and drink that only the rich could afford.
Gout is strongly associated with obesity, hypertension, diabetes, and hyperlipidemia.
Gout seems to run in families, indicating a genetic aspect.
Risk factors for gout include: obesity or weight gain, heavy alcohol ingestion, high blood pressure, abnormal kidney function, and hypothyroidism.
Other events which can precipitate a gout attack include taking certain medications, dehydration, fever, joint injury, and recent surgery.

Overview of Gout symptoms

Acute pain in the toe, swelling
The most common Gout symptom is acute pain in the big toe, which becomes tender, hot, and swollen in a few hours. It may also similarly affect other joints such as the knees and wrists, and sometimes more than one joint may be affected at a time. The attack, usually occurs at midnight or in the early hours of the morning when the patient is suddenly awakened. The acute attack generally lasts for a week or so. During this period, the patient may run a slight fever, and feel disinclined to eat. A serious complication of gout is the presence of kidney stones containing uric acid. In some cases the kidneys get damaged and do not function properly.

low fat dairy products- a BIG help

A study published in the New England Journal of Medicine on Mar 11, 2004 revealed that high intake of low-fat dairy products indeed reduces the risk of gout by 50%. It is unknown why low-fat dairy products offer a protective effect. Unfortunately, no natural supplements are proven effective to prevent or alleviate onset of acute gout attacks. The most effective treatment for gout attack is medication.

Tips on gout diet

Avoid High-Purine foods
Sweetbreads
Anchovies
Sardines
Liver
Beef kidneys
Brains
Meat extracts (e.g Oxo, Bovril)
Herring
Mackerel
Scallops
Game meats
Gravy

Use in Moderation
Vegetables: asparagus, cauliflower, spinach, mushrooms and green peas
Lentils, dried peas and beans
Beef, pork, poultry, fish and seafood
Oatmeal, wheat bran and wheat germ

Home Remedies

Read on for home remedy for Gout:

Apples are considered valuable in the treatment of gout. Consume an apple after every meal.
Extract the juice of half lemon and pour it in 1 glass of water. Drink it three times in a day.
The juice of French beans has proved beneficial in treating gout. Drink half cup of this juice everyday for about a month.
Bananas serve as an excellent remedy for curing gout. Consume a diet of bananas for three to four days.