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Conditions General

Gout vs. Pseudogout: What is the Difference?

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Both gout and pseudogout are types of arthritis characterized by inflammation of a joint. Both are caused by an abnormal accumulation of crystals in a joint. Despite the similarities, there are important differences in gout vs. pseudogout.

Different Chemicals and Crystals

Gout is caused by an abnormal buildup of urate or uric acid. A certain amount of urate within the body is normal, and the excretory system expels any excess naturally. In a person with gout, the excretory system doesn’t expel enough urate, and it accumulates within the patient’s blood stream. As it accumulates, the urate forms crystals that typically gather in a joint and irritate and inflame it.

In pseudogout, the crystals are made of calcium pyrophosphate (CPP). The crystals form in the cartilage and eventually leak into the joint fluid. At this point, they cause a painful attack of arthritis. Researchers have not yet determined the cause of the abnormal buildup of CPP crystals, but they have noted that it tends to happen after an illness or injury involving the affected joint.

Gout vs. Pseudogout: Different Risk Factors

Various conditions can increase the risk of developing gout. As per the stereotype, obesity is one such risk factor, especially if the patient is also male and at least middle-aged. Gout is more common in men. Younger people can develop the condition, especially if it runs in their family. African Americans are more likely to develop it than are Caucasians. Health problems linked to gout include diabetes, high blood pressure, bone marrow disorders, some blood disorders and severe psoriasis. Diuretics and other medications that increase uric acid levels can also cause gout.

Gout has also been linked to certain habits. For example, drinking a lot of alcohol increases the chances of developing the condition. People who don’t get enough Vitamin C in their diet or drink too many sugary drinks are also more likely to develop it.

A susceptibility to pseudogout may run in families. Like gout, it is much more common in older people; most patients are at least 60 years old. Pseudogout is commonly seen in people who also have osteoarthritis, thyroid trouble and various disorders affecting the metabolism of iron, calcium or phosphate. Kidney problems increase the risk of developing both conditions. Unlike gout, neither gender nor ethnicity seems to affect susceptibility to pseudogout.

Different Joints are Usually Affected

On paper, gout can affect any joint, but about half of all cases involve the big toe. In many of the other cases, the wrist, fingers or heel are affected. Pseudogout most commonly involves the knee. Other common sites are the wrist, shoulder, hip or ankle.

What About Prevention?

So far, researchers have not found any links between pseudogout and a patient’s habits. For example, while there is a link between gout and obesity, no such link has been found for pseudogout and obesity.

A patient with gout might be able to prevent further attacks by cultivating healthy habits. If they drink, they should at least reduce their alcohol intake. If they are overweight, they should follow an exercise and diet regimen to lose weight.

Get All the Facts

If you are experiencing symptoms of either of these two conditions, make an appointment at Arora Hand Surgery to see how your situation can be addressed. You don’t have to live with your painful condition. Contact us today to schedule a consultation at our office in Macomb Township, West Bloomfield, Howell, or Warren.

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Conditions General

Gout and Pseudogout in the Hands

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You may have heard of gout before, but you may not know what it is or what it does. There are actually two different forms that we need to discuss: gout and pseudogout (calcium pyrophosphate deposition disease). Essentially, when one of these diseases sets in, salt crystals will settle and form around joints in the hands or feet. As the crystals build up, they begin to cause irritation in the joints themselves as well as in tendons and other tissues in the area. Both forms of the disease will cause these buildups in the joints, but the actual material is different.

  • With gout, the buildup around the joints will be monosodium urate.
  • With pseudogout, the buildup around the joints will be calcium pyrophosphate.

This most commonly effects the joints in the hand as well as the big toe, the knee, and the wrist. Often, when people have one gout attack, they will have recurring attacks in the months and years to come.

What Causes Gout and Pseudogout?

Gout is caused when your body is producing too much uric acid, or alternatively, it is not excreting enough uric acid. This can happen due to medical conditions like hypothyroidism, heart disease, and kidney disease. Additionally, medications used for transplant patients, blood pressure medicines, blood thinners, and other can cause this change in the body.

Additionally, some people have developed gout after they have had surgery on a joint, there was an injury to the area, or there was an infection. Drinking alcohol has shown to cause flare ups.

Pseudogout or CPPD is usually caused when a patient has more than one injury to the same joint. It isnt connected with diet, medication, or other health problems. However, there does seem to be some correlation between people who have pneumonia, heart disease or stroke. Patients who have thyroid problems and develop an iron overload have developed CPPD as well.

The Symptoms

Symptoms of gout and pseudogout include:

  • Severe pain in the joint that will become extremely painful between four and 12 hours after it starts.
  • Discomfort that continues weeks after the pain subsides.
  • Redness, swelling, and inflammation in the affected joint.
  • Inability to use the joint properly, decreasing mobility.

A doctor will use examinations, x-rays and lab work to determine if you have gout or pseudogout.

The Treatment

Treatment for these diseases isnt designed to cure gout, but instead to decrease the inflammation in the joint and ease pain. Certain NSAID pain relievers have shown to be very effective in taking away pain. If the inflammation is bad enough, then the doctor may prefer a steroid injection. If the flare-ups cause enough problems, then surgery may be needed to remove the crystals from the joint.

If gout is left untreated, then it can permanently damage joints as the crystals can erode away at the bones and tissues. It is very important that you get treatment, so if you believe that you have gout in your hand, wrist, fingers, or any joint, be sure to schedule an appointment as soon as possible.

Resources:

http://www.mayoclinic.org/diseases-conditions/gout/basics/symptoms/con-20019400

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Dr. Aroras office from my first call to schedule my appointment was friendly. Walking in the first day, I felt like I was in a nice atmosphere. Dr. Arora was EXCELLENT in taking great care of my hand injury. He was gentle and very understanding to the concerns I had about my hand. His expertise was admirable and I would recommend anyone with an injury to their hand to his office to be under his care. Because of him, I have healed faster than expected and will make an 100% recovery! Thank you Dr.

Jackie S.

I first thought I was going to have to have painful injections or surgery, but Dr. Arora suggested physical therapy may do the trick. I was doubtful, but I agreed to do it. Now, my pain is gone, and with the help of an ergonomic keyboard at work to keep my hands in the correct position, I am virtually pain free. The therapy strengthened my wrists and shoulders, and built more flexibility into my wrists.

Jerry T.

My experience with this doctor was positive from the outset. Dr. Arora was kind and spent a great deal of time with me. Staff was friendly. The office was nice and bright.

Ariel G.

Very friendly and helpful Great staff!!! Doctor Arora was very professional and did great work. I was very happy with everything!

L B.