Gout and pseudo gout. What's the difference?Gout and pseudo gout are not the same, but at first glance may seem so. Gout is characterised by deposits of monosodium urate crystals (MSU). Pseudo gout, often misspelt as sudo gout, or psudo gout, is caused by crystals made from calcium pyrophosphate dihydrate. Hence it's sometimes called CPPD disease, or to spell it out just once, calcium pyrophosphate dihydrate deposition disease. SIMILARITIES Pseudo gout symptoms are also inflamed and painful joints. Both gout and pseudo gout may be accompanied by a fever. Gout and pseudo gout triggers that are alike are joint injuries, and perhaps transplants. They have similar names probably because of the pain, inflammation and joint stiffness both cause. Their similarity may cause confusion in the correct diagnosis of both gout and pseudo gout. DIFFERENCES But there are significant differences. Pseudo gout crystals are made from a different substance to the MSU gout crystals, and they can usually be viewed on an X-ray machine whereas gout's MSU crystals cannot. For gout to be diagnosed, the crystals need to be identified as MSU gout crystals under a special microscope. Furthermore, pseudo gout is much more likely to develop in men and women equally, and who are over 65 years old. And worsen as they age. Gout is likely to start in men between 40 and 60, and in women after the menopause, (although it too may worsen as patients age). MSU gout crystals are largely made from uric acid, whereas pseudo gout crystals are made from calcium pyrophosphate dihydrate. Gout and pseudo gout attacks too have a difference. Gout attacks usually develop quickly, frequently overnight. Pseudo gout attacks usually build up over a number of days and are normally less severe than gout attacks. Gout's immediate cause is that uric acid forms crystals, whereas pseudo gout's cause is unknown. Gout frequently starts in the joints of one of the big toes, whereas pseudo gout may start in the knees but not usually the big toe joint. Gout may be cured by lowering uric acid levels, or by the action of alkalizing agents. Or by another action of baking soda (bicarbonate of soda) apart from its effect as an alkalizing agent. And by natural remedies. Its cure involves dissolving crystals. Pseudo gout can be treated successfully, but not cured. Gout's long term causes i.e. abnormalities of purine metabolism, excessive purine intake and uric acid levels, and insulin resistance, are not suspected to be pseudo gout's causes. Theories of these for pseudo gout include: osteoarthritis; cartilage injuries causing the release of calcium crystals into the joint; excessive iron for genetic reasons; an under active thyroid gland; and excessive blood (serum) calcium. These are all different to gout's long term causes. PSEUDO GOUT TREATMENT Pseudo gout is treated with NSAIDs, colchicine and sometimes, in severe cases, corticosteroids, just like gout. It may also be treated by an aspiration surgery to remove its crystals-saturated fluid, from the affected joint(s). These treatments usually work to relieve pain and inflammation but pseudo gout attacks can return and over the longer term cause joint degeneration in serious cases, just like gout. Unlike gout, tophi do not develop. Return attacks are usually treated successfully. However, in the end, surgery may be required to replace the affected joint(s) of pseudo gout. If you've read around this site you'll know there's much you can do to prevent gout. With pseudo gout, this doesn't appear to be the case.
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