Diagnosing Pseudogout and How it is Treated

Diagnosing pseudogout will often require more than one diagnostic test. Since the CPPD crystal-related joint damage can sometimes mimic the symptoms and signs of rheumatoid arthritis and osteoarthritis, it is important that the doctor thoroughly investigate the patients signs and symptoms to ensure they accurately diagnose this condition. Once this condition is accurately diagnosed, the proper treatment for pseudogout can begin.

Diagnosis

Diagnosing pseudogout often begins with ruling out gout. The doctor will also work to rule out other conditions that may cause the same or similar signs and symptoms, such as infection, rheumatoid arthritis, and injury. The doctor will also visually examine the affected joint.

A joint fluid analysis may be performed. This test involves extracting a joint fluid sample by inserting a needle into the affected joint. This fluid is then analyzed under a microscope to determine if any CPPD crystals are present in the fluid.

X-rays of the affected joint can be used to look for joint damage and deposits of the crystal in joint cartilage.

Treatment

Treatment is geared towards relieving inflammation and pain. Resting the affected joints is always recommended. During an episode, the patient’s doctor may recommend they limit their activity. Rest is often accompanied with medications prescribed to alleviate swelling and pain.

Non-steroidal anti-inflammatory drugs may be prescribed to reduce pain and swelling. Commonly used NSAIDs include ibuprofen, indomethacin, and naproxen. There are risks associated with this type of drug, such as decreased kidney function and stomach bleeding. These issues are most common in older adults.

Joint aspiration and injection is a treatment method that may be used. This treatment method is done to relieve pressure and pain in the affected joint. The doctor begins by inserting a needle into the affected joint. He then extracts some joint fluid. The doctor will then inject a corticosteroid into the joint. The corticosteroid helps to decrease inflammation. An anesthetic in also injected to numb the joint temporarily. This procedure is typically not painful, but it can be uncomfortable.

Colchicine is a medication that is typically prescribed to those with gout to reduce inflammation. Pseudogout patients who are unable to take non-steroidal anti-inflammatory drugs may find this drug beneficial in reducing inflammation. Common side effects may include nausea, vomiting, and diarrhea. Rare side effects may include intestinal bleeding and bone marrow suppression. The patient’s doctor will often begin treatment by prescribing the lowest dose he can to minimize potential side effects. This is usually two tablets a day maximum. If the dose needs to be raised, the doctor will raise it over time to try and keep the patient’s side effects to a minimum.

Resources

MayoClinic.com. (2010). Pseudogout. Retrieved on November 20, 2010 from MayoClinic.com: https://www.mayoclinic.com/health/pseudogout/DS00717

MedlinePlus. (2010). Pseudogout. Retrieved on November 20, 2010 from MedlinePlus: https://www.nlm.nih.gov/medlineplus/ency/article/000421.htm