Dr. M.J. Bazos,
Pseudogout refers to
gout-like attacks, characterized by acute localized pain and swelling, that
occur in patients with calcium crystal deposits in the joints. Chondrocalcinosis
is the term used to describe the calcium-containing deposits that are found in
cartilage and which are usually visible on joint
is caused by deposits of calcium pyrophosphate crystals in joint tissues. In
most cases, crystals form without a known specific reason. In some instances, a
pattern of afflicted family members suggests a genetic disorder, possibly an
enzyme deficiency. Disorders of the thyroid or parathyroid glands may also be
- Pseudogout afflicts about 3% of people in their
60s and increases with age to as high as 50% in people over 90.
- Acute attacks of pseudogout often occur in the
knees and are incapacitating for days or weeks.
- Crystal deposits can contribute to a severe form
of joint degeneration resulting in chronic disability.
is diagnosed by finding crystals in fluid removed by a needle from affected
joints. X-ray findings of chondrocalcinosis are frequently seen in these
patients. Other causes such as gout and infection must be ruled
anti-inflammatory drugs and corticosteroid joint injections are successful in
shortening the period of pain and dysfunction of acute episodes of pseudogout.
Treatments to prevent attacks, such as colchicine, may be effective.
Unfortunately, no treatment is available to dissolve the crystal deposits.
Controlling inflammation helps to halt the progression of joint degeneration
that often accompanies
RHEUMATOLOGIST’S ROLE IN THE TREATMENT OF
actively engaged in research into the causes of pseudogout so that more
effective preventive and therapeutic interventions can be devised. Special
skills in the use of anti-inflammatory drugs are required in treating pseudogout
since the affected senior population is more susceptible to side effects these
medicines. A rheumatologist may need to evaluate the patient on the advisability
of surgery on arthritic joints. Rheumatologists direct a team approach to the
chronic, degenerative consequences of crystal deposition. Involvement of
physical and occupational therapists, counselors and nurses may be needed.