Many forms of arthritis occur gradually, and in the early stages a person may experience only occasional, mild pain. In contrast, pseudogout strikes quickly, severely and without warning. In fact, pseudogout can cause such severe pain that a patient believes the condition is life-threatening; it is not uncommon for an accurate diagnosis to be delayed while more serious medical conditions are considered.
Typical pseudogout symptoms are:
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A larger joint is affected. Both gout and pseudogout can affect any joint, however, pseudogout tends to affect the knee, shoulder, elbow, ankle, wrist, large knuckles, hip or spine, whereas more than half of gout cases involve the big toe, instep, heel or fingertips.
Pain. The most notable symptom of pseudogout is extreme pain at the affected joint.
Swelling. Fluid buildup in the joint can cause dramatic swelling.
Discoloration. The skin at and around the joint may appear red or purple.
Warmth. The skin at and around the joint will be warm to the touch.
Stiffness. Swelling and pain may significantly reduce the joints range of motion.
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Rapid onset. Acute pseudogout can develop suddenly and without warning, taking 6 to 12 hours for pain and swelling to reach their most severe.4
Short duration. Left untreated, an episode of pseudogout can last from 5 to 14 days, during which time the pain tapers off. No symptoms are present between episodes, but successive episodes may last longer.3,5
Fever. The person may get a fever as the immune system reacts to the calcium pyrophosphate crystals.
Unlike gout, which often strikes in the middle of the night, pseudogout is likely to occur at any time of day. Another notable difference in the two diseases is that recurrent cases of pseudogout do not result in tophi. Tophi (sing. tophus) are small white or yellow chunks of uric acid crystals that can be visible through the skin, and can occur in people who have suffered from chronic gout for several years.
- Cleveland Clinics. Disease Management Project: Gout and Pseudogout. ©2000-2010. Accessed May 24, 2012. www.clevelandclinicmeded.com.
- Zhang et al. European League Against Rheumatism recommendations for calcium pyrophosphate deposition. Part I. Ann Rheum Dis. 2011 Apr;70(4):563-70. Epub 2011 Jan 7. PubMed PMID: 21216817.
- Ivory D, Velázquez CR. The forgotten crystal arthritis: calcium pyrophosphate deposition. Mo Med. 2012 Jan-Feb;109(1):64-8. Review. PubMed PMID: 22428450.