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Pseudogout
Pseudogout, or CPPD, is a disease very similar to gout. Gout and
CPPD are often confused due to their similarities in onset. The
cause of CPPD is unknown and seems to effect both men and women
equally.
X-ray findings are similar with one exception. Individuals with
CPPD with show small islands of calcium deposition in the lining
of the joint referred to as calcinosis.
Diagnosing CPPD may only be made by testing a small sample of
the synovial fluid from the affected joint. Gout and CPPD can be
differentiated by specific testing and identification of the
type of crystal.
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Treatment of CPPD
The most significant consideration in the treatment of CPPD is
controlling the frequency of attacks. Frequent attacks (more
than one a year) will result in progressive erosion of the
joint, leading to painful chronic arthritis. Isolated attacks
(less that one a year) lead to minimal destruction of the joint.
The frequency of CPPD attacks determines whether treatment is
merely for each attack, or whether daily medication should be
taken to lower levels of inflammation.
Treatment of acute attacks includes the use of non-steroidal
anti-inflammatory medications such as Indocin or Clinoril.
Control of pain may require a mild narcotic such as codeine.
Recurrent attacks may be contolled by the use of an NSAID.
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Symptoms:
The symptoms of pseudogout are similar to gout showing an
abrupt onset and significant pain. Xray finding may resemble
gout with juxtachondral (immediately next to the joint) erosions
of the bone.
Differential Diagnosis:
The differential diagnosis for this condition should include;-
fracture
gout
osteoarthritis
infection of the joint
rheumatic fever
About the author:
Jeffrey A. Oster, DPM, C.Ped is a board certified foot and ankle
surgeon. Dr. Oster is also board certified in pedorthics. Dr.
Oster is medical director of Myfootshop.com and is
in active practice in Granville, Ohio.
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