Gout and Pseudogout
Gout is recognized as one of the most intensely painful types of arthritis. Pain, inflammation, swelling, warmth, and redness of a single joint are typical symptoms associated with gout. The most common joint affected is the big toe, but other joints can also be affected.
Cause of Gout Versus Cause of Pseudogout
Gout is caused by the accumulation of excess uric acid in the body resulting in the formation of crystals that are deposited in the joints. The deposition of uric acid crystals in the joints causes the inflammatory response. Uric acid is a by-product of the breakdown of purines found in all human tissues and many of the foods you eat. Gout can result from excess production of uric acid in the body or insufficient elimination of uric acid by the kidneys. Gout may be triggered by:
Eating a diet of purine-rich foods
Excessive alcohol intake
The use of certain medications
Pseudogout, as the name implies, is a condition that is often mistaken for gout. A different crystal is involved in pseudogout, however. In pseudogout, calcium pyrophosphate crystals are deposited in the joints. The condition is also referred to as calcium pyrophosphate deposition disease or CPPD. The knees are the most commonly affected joints with pseudogout. Wrists, shoulders, ankles, elbows, or hands can also be affected. Pseudogout may be triggered by:
Low magnesium blood levels
Do gout attacks typically come on gradually or occur suddenly?
Gout attacks typically develop very suddenly, and it is common for the first gout episode to occur at night. People can wake with a red, swollen, inflamed toe (or other joint) after going to bed without any signs or symptoms.
Diagnosis and Treatment
The symptoms of gout and pseudogout can be mistaken for other types of inflammatory arthritis. A proper diagnosis comes from identifying the crystal in the fluid of the affected joint. Your doctor will aspirate the fluid from the joint and examine it under a microscope for the presence of the crystals. In gout, the crystals may also be found in tophi, which are deposits found under the skin.
Gout is typically treated with diet modification, weight reduction, adequate fluid intake, and the use of medications that control the inflammation (e.g., NSAIDS or corticosteroids). Other gout medications include: colchicine which treats acute gout attacks, probenecid which helps with elimination of uric acid, and allopurinol which blocks production of uric acid.
Pseudogout is also treated using anti-inflammatory drugs and low doses of colchicine.
Prevalence of Gout
The National Institutes of Health reports that gout accounts for 5 percent of all cases of arthritis. The CDC reports that about 5.1 million adults report having doctor-diagnosed gout.
Anyone can develop gout or pseudogout, but more men than women are affected by gout. Men over the age of forty and women past menopause are at greater risk. Pseudogout crystals are found in about 50 percent of people in their nineties.