Gout and pseudogout are both types of arthritis that result in sore and painful joints. Gout is caused by the accumulation of crystals made up of a naturally occurring molecule called monosodium urate. Crystals made of another material, calcium pyrophosphate, cause pseudogout. In both conditions, the crystals accumulate in the joints causing irritation that leads to red, swollen, and painful joints. Gout and pseudogout affect joints of the foot, ankle, wrist, fingers, and knees. The most commonly affected joint for those with first time gout is the large toe.
Gout and pseudogout are diagnosed based on physical exam, X-rays, and laboratory tests. X-rays are helpful because they enable clinicians to see calcium deposits in those with pseudogout. Monosodium urate crystals cannot be seen on X-rays, but bone changes may be present to support the diagnosis of gout. A person’s response to treatment can also help a health care provider confirm the diagnosis.
The goal of treatment is to decrease swelling, redness, and pain. Nonsteroidal anti-inflammatory drugs (NSAIDs), steroids, and colchicine can be used for both gout and pseudogout. Other treatments include local physical therapy to the affected area and arthroscopy, which can be used to evaluate the joint and clean out debris. Surgery is reserved for those whose joints or tendons, the tissue that connects muscles to bones, have been damaged by the disease.