Pseudogout, or chondrocalcinosis is the deposition of calcium pyrophosphate dehydrate cyrstals in the hyaline cartilage or fibrocartilage (CPPD). This condition occurs more in older age groups and 1/3 of patients are over 75 years of age. X-ray changes of chondrocalcinosis is seen in the knees on radiograph. Gout affects more distal joints. Pseudogout tends to affect more proximal joints. An x-ray will show calcification of the meniscus in the knee or triangular fibrocartilage in the wrist. It is important for physicians to rule out endocrine or metabolic diseases such as hyperparathyroidism, hypophosphatasia, hemochromatosis, rheumatoid arthritis, or hypothyroidism. Additionally, gout must be ruled out as a differential diagnosis.
Pseudogout presents itself by asymptomatic radiographic findings alone in acute crystal induced synovitis. Chronic arthropathy is commonly seen in the knee and wrist but may also occur in the acetabulum labrum, symphysis, pubis, and annulus fibrosus of the disc. Aspiration shows rhomboid shaped crystals weakly positive. Treatment typically consists of NSAIDs and steroid injections.
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