What is pseudogout?

• Pseudogout results from a build up or precipitation of calcium (calcium pyrophosphate dihydrate) crystals in the joint causing inflammation and swelling in the joint. This swelling is in reaction to the calcium crystals in the joint.
• The calcium crystal and chronic inflammation in some people make parts of the joint structure weaken and break down.
• Cartilage, which cushions the ends of the bone, begins to pit and crack and bits of it break off into the joint space.
• After many years of cartilage erosion bones may actually rub together and this adds to the pain.

How common is pseudogout?

• Pseudogout affects middle-aged and elderly people.

What causes pseudogout?

• Risk factors for pseudogout include family history, age (>60), certain metabolic diseases, surgery or trauma.
• Too much calcium in the diet does not cause pseudogout.

How do you know if you have pseudogout?

• Pseudogout can present as sudden and repeated attacks of pain and swelling in one joint. There may also be stiffness and increased heat at the affected joint.
• Usually the knees are affected by pseudogout but it can also affect the wrist, elbow, shoulder and ankle.
• Your medical history and physical examination will help determine if you have pseudogout.
• X-rays and blood and joint fluid tests may also be necessary.

How is pseudogout treated?

• There is no cure for pseudogout but there are steps you can take to reduce pain and stiffness and make movement easier.

Medication

• When calcium crystals cause swelling and tissue damage you may be given a nonsteroidal anti-inflammatory drug (NSAID).
• NSAIDs may increase your risk of stomach upset and bleeding in the gut. Let your doctor know if you experience stomach pain, indigestion or black stools.
• Other prescribed medications are the recently approved cyclooxygenase-2 inhibitors (COX-2) class of medications. Like other NSAIDS, COX-2 selective inhibitors (SIs) have similar effectiveness to older NSAIDs in reducing pain and swelling. COX-2 SIs do not prevent joint damage. COX-2 SIs may be used if you are at risk of stomach upset or other gastrointestinal (GI) risk factors. Recent studies have suggested that COXIBs may be associated with an increased risk of cardiovascular side effects and this should be discussed with your doctor.
• For severe pain and swelling, fluid from the affected joint is removed. Your doctor may also inject a corticosteroid, a powerful anti-inflammatory drug, into the affected joint.

For medications prescribed by your doctor, it is important to know:

• Name(s) (generic and brand)
• How much to take
• When to take it
• How quickly will it work
• For how long should it be taken
• Side effects to look out for

Cold and Heat

• Heat helps relax aching muscles, joint pain and soreness, for example, a hot shower. However, this should not be used for an acutely inflamed joint.
• Cold helps numb an area, for example, an ice pack.

Exercise

• Exercise helps keep the muscles strong around the joint and maintains a healthy weight.

Protect Your Joints

• Pace yourself by alternating heavy or repeated tasks with easy ones or rest.
• Position your body to avoid stress on joints.
• Use helpful devices in your daily tasks such as carts, enlarged handles, canes and grab bars.

Relaxation

• Relaxing the muscles reduces joint pain
• Relaxation can include deep breathing exercises, listening to music, visualization, prayer, meditation or listening to relaxation tapes.

Surgery

• Surgery may be necessary for some people.

For More Information…

This fact sheet is just a brief look at pseudogout. For more information or if you have any questions, ask your doctor or pharmacist, or call The Arthritis Society at 1-800-321-1433. You can also visit The Arthritis Society's Web site at www.arthritis.ca.

Questions to ask your doctor at your next visit:

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This information is brought to you by an educational grant by McNeil Consumer Healthcare, the makers of TYLENOL* (acetaminophen)

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