Calcium Pyrophosphate Deposition 

Pseudogout comes on suddenly and causes intense pain in one or more joints. 

Calcium pyrophosphate deposition (CPPD) disease, commonly called “pseudogout,” is a painful form of arthritis that comes on suddenly. It occurs when calcium pyrophosphate crystals sit in the joint and surrounding tissues and cause symptoms like gout. Gout, however, is caused by a different type of crystal. The disease may cause lasting arthritis that may be mistaken for osteoarthritis, rheumatoid arthritis (RA) or gout.  

Developing pseudogout is more likely as a person ages. Almost half of people over 85 have the crystals, but many of them don’t have symptoms

In most cases, the cause of the crystal formation is unknown, although deposits increase as people get older. Because CPPD tends to run in families, genes may play a role. Other possible factors in its development include excess stores of iron; low blood magnesium levels; an overactive parathyroid; a severely underactive thyroid; or excess calcium in the blood. 
Pseudogout most often affects the knees, but can also involve the wrists, shoulders, ankles, elbows or hands. It comes in episodes that can arrive suddenly and last for days or weeks. Symptoms include: 
  • Swelling of the affected joint. 
  • Intense joint pain. 
  • Joint that is warm to the touch. 
  • Stiffness. 
  • Fever. 

Over time, the crystal deposits associated with pseudogout can cause ongoing inflammation and joint damage. This can mimic the symptoms of osteoarthritis or rheumatoid arthritis, including: 
  • Joint pain and stiffness. 
  • Low-grade inflammation. 
  • Knobby swelling at the joint – typically the knees, wrists, knuckles, shoulders, elbows or ankles. 
  • Decreased function of the joint. 
  • Morning stiffness and fatigue. 
Because CPPD resembles other forms of arthritis, it is difficult to diagnose based on a physical exam alone. Doctors often use a needle to take fluid from an affected joint to look for calcium pyrophosphate crystals, uric acid crystals (the cause of gout) or signs of infection. X-rays can also help make the diagnosis or rule out other causes of pain. Blood tests can help exclude other diseases. 
There’s no treatment available to dissolve the crystal deposits, but a combination of treatments can relieve pain and inflammation and improve joint function. Treatment often includes medications such nonsteroidal anti-inflammatory drugs (NSAIDs) or corticosteroids. For acutely painful and swollen joints, your doctor may insert a needle into the joint to remove some of the joint fluid and then inject the joint with a corticosteroid to decrease inflammation and a numbing medication to make it feel better temporarily. 

In severe cases, surgery to replace damaged joints is an option. 
In addition to taking prescribed treatments, it is important to rest painful joints. Ice packs can help reduce the pain and inflammation associated with flares. Excess weight increases inflammation in the body, so it’s important to maintain a healthy weight with exercise and healthy, balanced nutrition. 

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