Gout and Pseudogout

What is Gout?

Gout is a chronic disease characterized by flares of joint pain and swelling due to crystal deposition in the joint and surrounding tissues. Gout crystals are made of monosodium urate which form when uric acid levels remain elevated. It is the most common form of inflammatory arthritis worldwide. If untreated, gout can lead to irreversible joint damage and increased risk of comorbidities.

What are common symptoms and characteristics of Gout?
  • Affects men more than women
  • Difficulty with weight bearing
  • Fast onset
  • History of elevated uric acid or hyperuricemia
  • History of kidney, or renal, failure
  • History of similar episodes
  • Redness over the joint
  • Severe pain
  • Tenderness to palpation
  • Typically involves a singular joint, especially common in the big toe and lower extremities
  • Typically short duration
  • Use of medications that can cause elevated uric acid or hyperuricemia
Are there different types of Gout?

No, however, there is another type of crystal arthritis called pseudogout or calcium pyrophosphate deposition disease (CPPD). Like gout, pseudogout is characterized by flares of joint pain and swelling due to crystal deposition in the joint and surrounding tissues. Unlike gout, pseudogout crystals are made of calcium pyrophosphate.

What are common symptoms and characteristics of Pseudogout?
  • Affects women more than men
  • Associated with metabolic and endocrine disorders
  • Attacks may last weeks to months
  • May involve a single or multiple joints, especially common in the knee and wrist.
  • Redness over the joint
  • Severe pain
  • Tenderness to palpation
How are gout and pseudogout diagnosed?
  • physical exam
  • synovial (joint) fluid testing
  • uric acid (for gout)
What are the treatment options for gout and pseudogout?
  • Gout:
    • NSAIDs
    • Glucocorticoids
    • Colchicine
    • Urate lowering medications
      • Allopurinol
      • Uloric
      • Probenecid
      • Krystexxa
  • Pseudogout
    • NSAIDs
    • Glucocorticoids
    • Colchicine
What can patients do to help manage symptoms?
  • Gout:
    • Follow a low purine diet
    • Minimize alcohol intake
  • Both:
    • Exercise regularly
    • Manage comorbidities
    • Smoking cessation
    • Get adequate hydration
What other parts of the body are affected?
  • Increased risk for kidney stones
  • Increased risk for chronic kidney disease
  • Formation of tophi in soft tissues and organs