The Center for Podiatric Care and Sports Medicine

Assumed Name: Pseudogout

Posted by on Tuesday, August 14th, 2012

It’s always bad when someone accuses you of something that isn’t true, even if that accusation just comes in the form of a sideways glance or a raised eyebrow or two. For example, if you told someone that you had flare ups of nagging pain in your toe joints, it would not be unreasonable for that person to suggest that you have gout. Okay, that doesn’t sound that bad. Then you get the follow up raised eyebrows as the person looks at you and imagines the unhealthy, hard drinking, protein chomping, fat eating, salt shaking diet you must be pounding in order to develop gout. Wrong! You’re a vegan yoga instructor who hasn’t touched meat or alcohol in twenty years! So put that accusatory glance away! And by the way, how would a vegan yoga instructor who doesn’t drink get gout, a disease that afflicts people who drink hard and eat bad?

Maybe you, our imaginary vegan yoga instructor who shuns meat, salt, and alcohol do not have gout. Maybe you have pseudogout.

Okay, I am not a vegan non-drinking, non-salt eating yoga instructor, but I am interested in finding out more about this fake gout. Tell me more about gout and faux gout. That’s pseudogout to you.

Gout, as you no doubt remember, occurs when your body can’t rid itself of uric acid fast enough, causing the uric acid to crystallize around your joints leading to periodic flare ups of painful swelling and stiffness. Gout commonly occurs in your big toe joints and is associated with hypertension, high cholesterol, drinking alcohol and eating a protein heavy diet.

Pseudogout is painful swelling and stiffness around the joints due to a build up of crystals in your joints. However, in the case of pseudogout, the crystals don’t come from uric acid; rather, they’re salt crystals from a salt called calcium pyrophosphate dihydrate (CPPD).

So do you mean that pseudogout has the same symptoms as gout? Yes, that’s why it’s often mistaken for gout. Or osteoarthritis or rheumatoid arthritis.

Then how do I know whether I have gout or pseudogout? Well, for one thing, if you don’t drink much or eat a diet high in protein, then you can legitimately doubt you have gout even if your symptoms seem gout-ish. Also, pseudogout mostly affects older people, though younger people who have acromegaly, hemochromatosis, ochronosis, parathyroid disease, thyroid disease, or Wilson disease may be vulnerable to it. So you can do some process of elimination based on your age, diet, and general health, but to get an accurate diagnosis you should see a podiatrist at The Center for Podiatric Care and Sports Medicine (212.996.1900).

What’s the treatment, then? Well, regular gout is just a matter of lifestyle and diet changes. People who have pseudogout or CPPD, though, mostly just have to manage the pain. They may need to have fluid around their joints aspirated, or withdrawn by a needle. Steroid injections can also help with painful swelling. Non-steroidal anti-inflammatories can help with the frequency and severity of flare ups. Foods that fight inflammation can also help. It’s important to treat the condition in some way; left on its own, CPPD can damage joints.

Does gout get annoyed that there’s another disease going around acting all gouty? I’m sure gout is often just glad to pass the blame onto someone else.

The moral of this story is this: if you’re a person who leads a gout inducing lifestyle, try to make changes that will make you less likely to get gout; if you’re a person who does not do the kinds of things that cause gout and you suddenly find yourself seeming gouty, get it checked out!

If you have any foot problems or pain, contact The Center for Podiatric Care and Sports MedicineDr. Josef J. GeldwertDr. Katherine Lai, Dr. Ryan Minara and Dr. Mariola Rivera have helped thousands of people get back on their feet. Unfortunately, we cannot give diagnoses or treatment advice online. Please make an appointment to see us if you live in the NY metropolitan area or seek out a podiatrist in your area.