The following are the signs and symptoms of pseudogout:

• Affected joints are painful.
• There is fluid buildup in the joints.
• Affected area is warm to touch.
• Pseudogout may sometimes present with tophi [9].

• Fever

  The patient exhibited severe neck pains, headache, high fever and a pain in his knee joints together with symptoms of the central nervous system. The patient's cerebrospinal fluid was almost clear and showed no sign of viral infection. [ncbi.nlm.nih.gov]

  Medicines NSAIDs, such as ibuprofen, help decrease swelling, pain, and fever. This medicine is available with or without a doctor's order. NSAIDs can cause stomach bleeding or kidney problems in certain people. [drugs.com]

  Postoperative Course Approximately 5 weeks after surgery, the patient presented to the emergency department with 2 days of midback spasms, fever, and chills. Her temperature was 102 F, and blood inflammatory markers were elevated. [thejns.org]

  He denies any fevers or chills. His exam reveals a moderate knee effusion and diffuse pain and tenderness with palpation and range of motion. Weightbearing radiographs are shown below. [orthobullets.com]

• Abdominal Obesity

  obesity, elevated triglycerides, hypertension, hyperlipidemia, hyperglycemia) Diabetes Chronic renal failure Medications increasing urate levels: Diuretics, cyclosporine, low-dose aspirin When urate accumulates in a supersaturated medium, it can deposit [clevelandclinicmeded.com]

  Whether this is directly attributable to hyperuricemia or gout or to gout-associated diseases (eg, insulin resistance, type 2 diabetes mellitus, abdominal obesity, hypercholesterolemia, or hypertension) has been much debated. [63, 64, 65] Although no [emedicine.com]

• Swollen Knee

  Some of the most common signs include: A swollen knee joint that feels warm when touched and extremely tender Episodes of intense and sudden joint pain Chronic arthritic pain Fluid accumulating around the joint. [hrosm.com]

  Wondering about that suddenly painful and swollen knee, elbow, or wrist? The cause of your troubles may be pseudogout, or calcium pyrophosphate dihydrate (CPPD) deposition disease. [everydayhealth.com]

  Signs of haemarthrosis are: swelling of the knee warmth stiffness and bruising, which occur soon after the injury Go to A&E immediately for treatment if you have a very swollen knee following an injury. [nhs.uk]

• Soft Tissue Mass

  Radiographs and computed tomography showed meniscal calcification with an abnormal soft-tissue mass surrounded by calcification. After excision, massive calcified deposits were seen both inside and on the surface of the tophaceous pseudogout. [ncbi.nlm.nih.gov]

• Trismus

  We present a case of a 71-year-old woman who presented with worsening facial pain, trismus, and a large mass in her infratemporal fossa with minimal associated temporomandibular joint destruction. [ncbi.nlm.nih.gov]

  There was no increase in swelling periprandially, although he was unable to eat at that time because of trismus and pain. He gave a history of hypertension and angina, for which he took nifedipine and isosorbide mononitrate. [nature.com]

• Conjunctival Nodule

  nodules, band keratopathy, blurred vision, anterior uveitis (rare), scleritis Complications of gout include the following: Severe degenerative arthritis Secondary infections Urate or uric acid nephropathy Increased susceptibility to infection Urate nephropathy [emedicine.com]

• Knee Pain

  BACKGROUND: Symptomatic knee joint effusion is frequently observed after hip fracture, which may lead to postoperative knee pain during rehabilitation after hip fracture surgery. [ncbi.nlm.nih.gov]

  (SBQ07SM.13) A 53-year-old male laborer presents to his primary care physician with complaints of acute onset of left knee pain. He has had mild episodes of knee pain in the past and is two years status post a left partial medial meniscectomy. [orthobullets.com]

• Joint Swelling

  Pseudogout or calcium pyrophosphate deposition disease (CPDD) is a form of inflammatory arthritis caused by crystals forming in the joints. [hss.edu]

  This leads to attacks of joint swelling and pain in the knees, wrists, ankles, and other joints. Among older adults, CPPD is a common cause of sudden (acute) arthritis in one joint. [mountsinai.org]

  These crystals irritate the joints, and cause the body to release chemicals that make the joints swell. This results in the irritated area of the hand to become painful and appear red. [arorahandsurgery.com]

  Joint swelling occurs, as well as local heat and thickening of the lining of the joint – the synovium. Accumulation of fluid is called an effusion. Course The prognosis is usually good, but severe joint damage can occur. [health24.com]

  Pseudogout: a rare cause of joint swelling during postoperative period Kant Sahu, Ajay Kumar Mishra and Dhinager Nandagopal Department of Internal Medicine, Saint Vincent Hospital, 123 Summer Street, Worcester, MA, USA Correspondence to Dr Kamal Kant [casereports.bmj.com]

• Arthralgia

  In this case, a 56-year-old caucasian male presented with right sided preauricular swelling, temporomandibular joint arthralgia and restricted mouth opening; he developed identical symptoms on the left side two days later. [ncbi.nlm.nih.gov]

  These joint symptoms include : Pain in the joints (arthralgia) Swelling of the joints Warmth of the joint The symptoms may resolve and a person may be asymptomatic until another attack recurs. [healthhype.com]

  Pseudogout is one of the common entities causing arthralgia and arthritis in the elderly. Ramonda et al. reported the prevalence of chondrocalcinosis to be 10.4% in older Italians [13]. [hindawi.com]

  CPPD disease varies from asymptomatic deposition of calcium pyrophosphate in the cartilage of the knees and wrist to arthralgia or acute synovitis. Additional sites of acute symptoms may involve the other above described sites. [now.aapmr.org]

• Joint Effusion

  Treatment with non-steroidal anti-inflammatory drugs and aspiration of the joint effusion had not been effective. The mass continued to enlarge, and the patient had difficulty walking. [ncbi.nlm.nih.gov]

  Within several hours the joint becomes warm and swollen and a large joint effusion develops. [thecardiologyadvisor.com]

• Knee Effusion

  Knee effusion was assessed on admission and at the operating room before the surgery. [ncbi.nlm.nih.gov]

• Preauricular Swelling

  In this case, a 56-year-old caucasian male presented with right sided preauricular swelling, temporomandibular joint arthralgia and restricted mouth opening; he developed identical symptoms on the left side two days later. [ncbi.nlm.nih.gov]

• Facial Pain

  We present a case of a 71-year-old woman who presented with worsening facial pain, trismus, and a large mass in her infratemporal fossa with minimal associated temporomandibular joint destruction. [ncbi.nlm.nih.gov]

  The rarity of pseudogout in this joint may be partly due to a failure to recognize this diagnosis as a cause of facial pain. This content is only available as a PDF. Oxford University Press I agree to the terms and conditions. [academic.oup.com]

Signs and symptoms of pseudogout are similar to those of gout. Therefore, it is necessary to carry out various tests to arrive at a definitive conclusion. The following methods are employed to diagnose pseudogout:

• Laboratory tests to detect the presence of crystals in the joints are done. In this, fluid is retrieved from the joints and is tested for the presence of crystals. In addition, blood tests may also be carried out to determine other underlying conditions such as thyroid disorders or mineral imbalances that can give rise to pseudogout.
• Imaging studies such as X-ray of the affected joint is done to determine the extent of damage to the joint. An X-ray examination of the joint would also reveal deposition of crystals.

Pseudogout cannot be cured, however various treatment methods can help in effective management of the condition. Treatment regime is geared towards relieving the symptoms and discomfort experienced due to the arthritic attack. The following methods are employed for management of pseudogout:

• Medications such as nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids and colchicines are administered for relieving the inflammation and the associated pain in the affected joint. Individuals who are prone to suffer from recurrent attacks of pseudogout are advised to take colchicines as prophylactic measure.
• There is accumulation of fluid in the affected joint that leads to pain and inflammation. This fluid is drained with the help of a needle or scalpel (surgical decompression) which is inserted into the affected area to aid in fluid removal [10]. Such a kind of process also helps in removing significant amount of crystals from the joints.

Prognosis of the condition is usually favorable with timely initiation of treatment. Affected individuals are reported to do well with medications and other therapies. Acute attacks are known to resolve within 10 days of receiving treatment.

Complications

Complications occur when the individuals do not seek proper medical treatment. In such cases, the joint undergoes constant and permanent damage by the deposited crystals.

The deposition of calcium pyrophosphate crystals in the joints gives rise to development of pseudogout. What triggers the deposition of calcium salts is not known, but advancing age is thought to be the major factor. More than 50% of individuals aged 85 years and above have deposits of calcium salts in their joints. However, not all of them develop pseudogout. The reason behind this is still not understood. Genetic transmission has also been implicated in the expression of pseudogout [2].

Some of the risk factors contributing to development of deposition of calcium pyrophosphate crystals include the following:

• Hemochromatosis 
• Hypomagnesemia
• Hyperparathyroidism
• Hypercalcemia
• Hypothyroidism
• Acromegaly
• Wilson disease
• Intake of loop diuretics [3]
• Etidronate sodium therapy for osteoporosis [4]
• Dyes from diagnostic angiography [5]
• Spinal surgery [6]

Pseudogout is a common occurrence affecting about 1.3 per 1000 adult individuals. Incidence of pseudogout varies with age and older aged individuals, especially women, are known to be more affected by this condition.

It has also been estimated that about 30% of individuals above the age of 60 years and 50% individuals above 90 years were found to have deposits of calcium crystals in their joints. In addition, there is a considerable amount of risk associated with onset of pseudogout and development of heart diseases in the affected individuals.

Deposition of calcium pyrophosphate (CPP) crystals in the joints of individuals gives rise to pseudogout [7]. The exact factor that triggers such a kind of event is yet to be figured out. The deposition of the calcium pyrophosphate crystals in the joints causes the area to swell and be painful. The affected area also feels warm when touched.

The knee is the most common joint for development of pseudogout; however other areas such as ankle and wrist can also be affected. There are crystal arthropathies that involve both pseudogout and gout at the same time [8].

Pseudogout cannot be prevented. However, the various conditions that can give rise to development of such a condition should be treated to avoid the onset of pseudogout.

Pseudogout also known as calcium pyrophosphate deposition disease is caused due to deposition of calcium pyrophosphate crystals in the joints [1]. It is a type of arthritis significantly affecting the knee and other joints. Pseudogout is a serious condition causing pain and inflammation and the attacks can last for several days to weeks, severely affecting the patients life.

Pseudogout needs appropriate diagnosis and prompt treatment to avoid worsening of the condition. Women fall easy prey to this arthritic condition as compared to males. Pseudogout received its identity in the year 1962 when the condition was described to have independent characteristic features from gout.

Definition

Pseudogout is a type of arthritis that severely affects the joints causing inflammation and pain. In this condition, crystals of calcium pyrophosphate get deposited in the joint. Females are more prone to contract this condition than males.

Cause

Age is known to be the most common factor for pseudogout. As individual ages, the crystals get deposited into the joints giving rise to arthritic pain. Certain underlying conditions are also known to give rise to pseudogout. These are thyroid disorders, parathyroid diseases, Wilson disease, acromegaly and hemochromatosis.

Symptoms

Symptoms of pseudogout precipitate as pain and inflammation in the affected joints. The affected area is also warm to touch. An attack of pseudogout lasts for several days and should usually resolve with prompt initiation of treatment. 

Diagnosis

Diagnosis of pseudogout is carried out by an X-ray examination of the joints that reveal the presence of crystals and damage to the area. In addition, laboratory tests are also conducted to determine the presence of any underlying disease conditions. In many cases, the fluid from the joint is also tested for the presence of crystals.

Treatment

Pseudogout cannot be cured. With appropriate medications and therapies the condition can be effectively managed and symptoms kept under control. Medications such as nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroids are employed for relieving the pain and inflammation in the joint. Individuals prone to frequent attacks are given colchicines as a preventive regime. Fluid that gets accumulated in the joints can also be removed to reduce the associated pain and inflammation.

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