Gout and pseudogout are characterized by acute or chronic arthritis due to deposits of crystals in and around joints. The deposition of monosodium urate crystals leads to acute gout and chronic tophaceous gout. The deposition of calcium pyrophosphate dehydrates (CPPD) crystals leads to pseudogout, also known as chondrocalcinosis. These conditions are among the most common causes of inflammatory arthritis. Identification of crystals in synovial fluid is the key to getting the correct diagnosis.
What Is Gout?
Gout is a disease caused by too much uric acid in your body. Uric acid can be deposited in various sites in the body including joints. Though excess uric acid may not cause symptoms at first, over time the accumulation of deposits may cause painful joint inflammation (arthritis). Most people who have gout are middle-aged men, but it can occur at any age. Only 5 to 10% of gout cases occur in women, usually after menopause.
What Does Gout Lead to?
The pain of acute gout is often extreme, especially in the first few episodes. The initial episodes frequently involve a single joint, usually the big toe. This can interrupt sleep, prevent walking, and interfere with work and leisure. When recurrent acute gout goes untreated and when there is a failure to eradicate causative factors, the condition may evolve in arthritis. There may even be deposition of urate crystals to form visible tophi or lumpy deposits under the skin. Swelling and deformity then become the characteristic signs, but without the intense inflammation.
How Is Gout Diagnosed?
Dr. Cohen or one of his esteemed associates may deem it necessary to aspirate fluid from an inflamed joint to determine whether the urate crystals are causing the problem. Also, blood and/or urine tests may be needed to assess the degree of increased uric acid in your body. Finally, standard x-rays may be necessary to determine if joint or soft tissue damage has occurred. If gout emerges as the diagnosis, Dr. Cohen will then discuss treatment options.
How Is Gout Treated?
The principle goal of treatment includes treating the acute attacks early and effectively. It is also important to correct factors that may contribute to increased uric acid. These include decreasing excessive alcohol use, correcting obesity or substituting diuretic therapy with another hypertension medicine. Also, ingestion of foods high in purines (precursors of uric acid), such as red meat, wine and beer needs to be decreased. Finally, medications to decrease the uric acid pool in the body can be instituted.
What Is Pseudogout?
Pseudogout is a chronic condition that results from the local overproduction of pyrophosphate in cartilage which causes the deposition of CPPD crystals. It is not known why the body forms these crystals, but the cause may be due to an abnormality in the cartilage cells or connective tissue. The cause also may be due to genetics and age.
Episodes of acute pseudogout occur when CPPD crystals are shed from the cartilage. This can happen after surgery, from direct trauma to the joint, or from joint inflammation. It usually appears as the sudden onset of swelling, warmth and pain in one joint, typically the knee (in 50% of attacks), wrist, or ankle. The degree of inflammation may be less than that seen in gout. Multiple joints may be affected and the condition may be accompanied by fever. Joint inflammation peaks on day two or three and can last from 7-14 days with subsequent resolution.
A chronic form of arthritis can develop with pain and deformity. This usually develops in the knees, but any joint can be affected.
How Is Pseudogout Diagnosed?
It may be necessary to aspirate fluid from your joint to identify crystals and make the appropriate diagnosis. Also, standard x-rays can show CPPD deposition, especially in the wrist and knee.
How Is Pseudogout Treated?
Episodes of acute pseudogout are treated in the same manner as acute gout. Aspiration of the affected joint often provides relief. Chronic arthritis is treated symptomatically with medicines to decrease the inflammatory response. At Cohen Medical Centers, we offer an infusion center and ultrasound-guided joint injections to help manage your pain and improve your health.
Gout and Pseudogout Treatment In Thousand Oaks, California
Known for their expert and compassionate care, Dr. Cohen and his esteemed team offer treatment for gout and pseudogout in Ventura County. To schedule an appointment, call us at (805) 449-8781 or fill out the form below, and someone from our helpful staff will get back to you.