II. Epidemiology
- Autosomal Dominant inheritance and sporadic cases
III. Associated Conditions
IV. Signs: Pseudogout (25% of CPPD Deposition Disease)
- Acute self-limited joint inflammation
- Duration of Pseudogout attack: days to weeks
- Asymptomatic between episodes
- Distribution (may involve any joint)
- Knees (50%)
- First metatarsophalangeal Joint (similar to gout)
- Pseudogout precipitating factors
- Spontaneous attacks
- Trauma
- Surgery
- Cerebrovascular Accident (CVA)
- Myocardial Infarction
- Systemic signs
- Fever up to 103 F
V. Signs: Pseudo-Rheumatoid (5% of CPPD Deposition Disease)
- Symmetric Polyarthritis with low grade inflammation
- Synovial thickening
- Flexion contractures
- Morning Stiffness
- Fatigue
VI. Signs: Pseudo-Osteoarthritis (50% of CPPD)
VII. Labs
-
Arthrocentesis for Synovial Fluid exam
- CPPD crystals on Polarized Microscopy
- General studies for CPPD Deposition Disease
- Pseudogout attack
- Complete Blood Count
- Leukocytosis up to 15,000 per mm3
- Erythrocyte Sedimentation Rate (ESR) increased
- Complete Blood Count
- Pseudo-Rheumatoid
- Erythrocyte Sedimentation Rate (ESR) elevated
- Rheumatoid Factor may be positive at low titer
VIII. Radiology: Joint XRay
- Screening XRays for CPPD Deposition
- Bilateral AP Knee XRay
- AP Pelvis XRay
- Symphysis Pubis
- Hips
- Bilateral PA Hand and Wrist XRay
- Articular hyaline cartilage changes
- Punctate densities
- Linear densities
IX. Management
- Large joint acute attack
- Analgesia
- NSAIDs
- Colchicine (Intravenous is more effective than oral)
X. References
- Klippel (1997) Primer Rheumatic Diseases, p.226-9
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| Definition (NCI) | An acute episode of pain, swelling, and redness, sometimes associated with fever. It is caused by the deposition of calcium pyrophosphate crystals in the joints. |
| Definition (CSP) | presence of calcium salts, especially calcium pyrophosphate, in the cartilaginous structures of one or more joints, accompanied by attacks of goutlike symptoms. |
| Concepts | Disease or Syndrome (T047) |
| MSH | D002805 |
| SnomedCT | 201624004, 268142006, 156881000, 60782007, 239834007 |
| English | Pseudogout, PSEUDOGOUT, pseudogout (diagnosis), pseudogout, pseudo-gout, pseudo gout, Pseudogout (disorder), Pseudogout, NOS |
| Dutch | pseudo-jicht, Pseudo-jicht |
| German | Kalkgicht, Pseudogicht |
| Spanish | Pseudogota, Seudogota, pseudogota (trastorno), pseudogota, seudogota |
| Japanese | 偽痛風, ｷﾞﾂｳﾌｳ |
| French | Pseudogoutte, Pseudo-goutte |
| Czech | Pseudodna, pseudodna |
| Hungarian | Álköszvény |
| Norwegian | Pseudogikt, Falsk gikt |
| Portuguese | Pseudogota |
| Italian | Pseudogotta |
