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Like gout, pseudogout is characterized by crystal-like deposits that settle in the joints and cause pain and warmth/redness, but these deposits are composed of a different substance: calcium pyrophosphate dihydrate (CPPD).
A Pseudogout is so named because--like gout--it is caused by a build-up of crystal-like deposits in joints.
Historically, various nomenclatures such as pseudorheumatoid arthritis, pseudoankylosing spondylitis, articular chondrocalcinosis, and pseudogout have been employed to describe CPPD disease (2, 4).
Analysis of aspirated bursa fluid in this case also revealed crystals consistent with pseudogout, and there are rare reports of mass-like presentations with gout and pseudogout [6, 7].
This was particularly evident in this case as the patient received five days of steroids for pseudogout prior to the first dose of denosumab.
* Continue medication for as long as patient requests and does not find treatment overly burdensome Calcium and * Can contribute to pruritus, restless legs phosphate syndrome, calcium, and phosphorous depositions imbalance leading to myalgias, arthralgias, and pseudogout * Treatment is aimed at relieving these symptoms, if present, rather than correcting laboratory abnormalities * Treatment involves phosphorous-restricted diet and phosphate binders Decreased * Can contribute to weakness, fatigue and muscle loss active Vitamin D * If vitamin D deficiency is felt to be contributing to symptom burden, an active form of vitamin D can be started such as calcitriol at 0.25ug three times a week.
Calcium pyrophosphate dihydrate (CPPD) crystal deposition disease is characterized by the deposition of CPPD crystals in the articular cartilage visualized as intra-articular calcifications [chondrocalcinosis (CC)], with identification of the crystals in the synovial fluid, and an acute arthropathy called pseudogout. (1)
The patient was sent for diagnostic imaging in consideration of differential diagnoses of gout, pseudogout, osteoarthritis, rheumatoid arthritis and septic arthritis.
Inappropriate activation of NLRP3 inflammasome has been linked to the pathophysiologic processes of many inflammatory diseases, such as gout, pseudogout, silicosis, and asbestosis [81-84].
Pseudogout is a condition similar to gout also characterized by periodic acute joint attacks that potentially turn into a chronic disease.
The study's results showed that ultrasound provided excellent specificity for gout in the setting of acute calcium pyrophosphate deposition disease (CPPD), also known as pseudogout, particularly in distinguish ing the deposition of monosodium urate on the surface of cartilage (double contour sign), and calcium pyrophosphate within the matrix of the cartilage (interface sign).
Although some doctors might treat for gout without one, the presence of large needle-shaped crystals within the joint fluid confirms the diagnosis and can be used to differentiate gout from pseudogout or septic arthritis.