•  Pseudogout

    Pseudogout, also known as calcium pyrophosphate deposition disease (CPPD), is a type of arthritis that leads to sudden and painful joint inflammation. It is characterized by the deposition of calcium pyrophosphate crystals in the joints, which triggers an inflammatory response. Pseudogout typically affects one or a few joints at a time, and the knee joint is the most commonly involved joint. However, it can also affect other joints such as the wrists, ankles, elbows, shoulders, and hips.

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    <p><a href="https://www.healthchoicesfirst.com/practitioner-type/rheumatologist">Rheumatologist,</a> discusses pseudogout and how it is diagnosed.</p>

    Rheumatologist, discusses pseudogout and how it is diagnosed.

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    <p><a href="https://rheumatology-now.com/local/local-rheumatologists">Rheumatologist</a><a href="https://www.healthchoicesfirst.com/practitioner-type/rheumatologist">,</a> talks about how pseudogout is treated.</p>

    Rheumatologist, talks about how pseudogout is treated.

  • Understanding and Diagnosing Pseudogout

    To diagnose pseudogout, a healthcare provider typically takes into consideration the clinical history and symptoms reported by the patient. Pseudogout is a form of arthritis that causes sudden and painful inflammation in one or more joints. It is characterized by the deposition of calcium pyrophosphate crystals in the affected joint, leading to an inflammatory response.

                          

    The key symptoms often reported in the clinical history of pseudogout include:

    1. Acute onset of pain and swelling: The individual may experience sudden and severe joint pain, accompanied by swelling and redness. The most commonly affected joints in pseudogout are the knee, wrist, and elbow, although other joints can also be involved.

    2. Previous episodes: A history of previous episodes of similar symptoms is often present in patients with pseudogout. The time interval between episodes can vary, ranging from months to years. This recurrent nature of symptoms can be an important clue in diagnosing pseudogout.

    It's important to note that a definitive diagnosis of pseudogout usually requires confirmation through joint fluid analysis. A sample of fluid is extracted from the affected joint and examined under a microscope to detect the presence of calcium pyrophosphate crystals. Additionally, imaging tests such as X-rays or ultrasound may be performed to assess joint damage or the presence of calcifications.

    If you suspect pseudogout based on your symptoms and clinical history, it's recommended to consult a healthcare professional for a proper evaluation and diagnosis. They will be able to assess your symptoms, conduct the necessary tests, and provide appropriate treatment options.                           

    If you suspect a diagnosis of pseudogout, there are several diagnostic steps that can be taken. These include blood tests, imaging, and analysis of synovial fluid. Here's a breakdown of the diagnostic procedures mentioned:

    1. Blood tests: The initial blood tests often include markers of inflammation such as erythrocyte sedimentation rate (ESR) or C-reactive protein (CRP) levels. Additionally, a uric acid level test is conducted to differentiate between gout and pseudogout. Elevated uric acid levels are more commonly associated with gout.

    2. X-rays: X-rays of the affected joint may be performed. In pseudogout, minor calcification along the joint's cartilage may be observed, which can support the diagnosis.

    3. Synovial fluid analysis: The most definitive way to confirm the diagnosis of pseudogout is by examining the synovial fluid obtained from the affected joint. A needle is inserted into the joint to extract the fluid. This fluid is sent for culture to rule out any possible infection. Moreover, the fluid is analyzed under a microscope to identify the presence of pseudogout crystals. The presence of these crystals confirms the diagnosis.

    If it is difficult to obtain enough synovial fluid for analysis, additional tests may be considered:

    1. Dual energy CT study: This is a specialized x-ray-based CT scan that can assess both small and large joints. It can help determine if the joint inflammation is caused by pseudogout or gout. The dual energy CT study is particularly useful when synovial fluid cannot be obtained from the joint.

    If you have any questions or concerns about the diagnosis of pseudogout, it is advisable to consult with your family physician, rheumatologist, registered dietitian, athletic therapist, or pharmacist. These healthcare professionals can provide further guidance and address your specific concerns. Remember to verify the information provided by contacting the healthcare providers directly, as network participation and availability can vary over time. Find local massage therapists physiotherapists and personal trainers to help with strength and conditioning if you are experiencing arthritis.

     

  • Treating Pseudogout

    Colchicine is a medication you need to respect, because it has side effects. Side effects of colchicine commonly include nausea and diarrhea. And if you push the dose of colchicine too high, sometimes the side effects of the medication are worse than the symptoms of the disease.

    So your specialist, local rheumatologist  will recommend you take one, two, three, perhaps colchicine for the first day. And then subsequently they may recommend that you reduce the dose of the colchicine in the coming days and then after a number of days, it would be recommended that you stop or come off the colchicine. Occasionally, pseudogout can be a chronic condition, and there are some times that your specialist will recommend that you stay on very low-dose colchinine on a daily basis. Sometimes you can reduce that to every other day. In treating this condition, often seeing a local massage therapist for muscle tension, a local personal trainer for muscle strength and a physiotherapist for release and conditioning is a good option. Getting a referral to a rheumatologist or your local pharmacist is also important in dealing with Arthritic conditions.  

    If you can’t take colchicine and you can’t take anti-inflammatories, there are some newer medications that are very effective in treating pseudogout. Those medications are biologic drugs, known as IL-1 inhibitors. The most common IL-1 inhibitor readily available is a drug called anakinra. Anakinra is a drug you give yourself, or a nurse gives you, on a daily basis. The dose is 100mg in a prefilled syringe. You will inject it under the skin, and usually taking anakinra 100 milligrams daily for three to six days is an extremely effective way of resolving the acute symptoms of pseudogout, if you fail the other therapies.

    If you have any questions or concerns about the treatment of pseudogout, speak to your healthcare provider or your specialist.

    The symptoms of pseudogout are similar to gout, which is caused by the deposition of uric acid crystals in the joints. The affected joint becomes swollen, red, warm, and extremely painful. The pain and inflammation can last for days or even weeks. Pseudogout episodes can recur intermittently over time.

    The exact cause of pseudogout is still not fully understood, but it is believed to be associated with the aging process, as the incidence increases with age. Certain factors may trigger or worsen pseudogout attacks, including trauma to the joint, surgery, dehydration, high levels of calcium in the blood, and certain medical conditions such as an underactive thyroid, iron overload (hemochromatosis), or parathyroid gland disorders.

    Diagnosis of pseudogout involves analyzing fluid extracted from the affected joint to identify the presence of calcium pyrophosphate crystals. Imaging tests such as X-rays or ultrasound may also be used to evaluate joint damage or to rule out other conditions.

    Treatment for pseudogout aims to relieve pain and reduce inflammation during acute episodes. This may include nonsteroidal anti-inflammatory drugs (NSAIDs), colchicine, corticosteroids, or joint aspiration (draining the fluid from the joint). In some cases, if the pseudogout attacks are recurrent or severe, medications may be prescribed to lower the levels of calcium in the blood.

    In addition to medication, lifestyle modifications such as maintaining a healthy weight, staying hydrated, and protecting the joints from injury or trauma may help in managing pseudogout. Physical therapy and assistive devices like braces or canes may be recommended to improve joint function and reduce the risk of future attacks.

    It's important to consult with a healthcare professional for an accurate diagnosis and appropriate treatment if you suspect you may be experiencing pseudogout or any other medical condition.

    The physicians are in good standing with the College of Physicians and Surgeons of Canada,  Canadian Rheumatology Association and the Canadian Medical Association

    Key Words: Ankylosing spondylitis (AS), Rheumatoid arthritis (RA), Psoriatic arthritis (PsA), Raynaud's phenomenon and  Hip replacement,  

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