Gout or Pseudogout?

Gout and “pseudogout” — known formally as calcium pyrophosphate dihydrate crystal deposition disease (CPPD) — have such similar symptoms that it usually takes a microscope to know for sure what you’ve got.
Each of these painful forms of arthritis is caused by a different type of crystal in the joints, and remedies differ.
“The big difference is that gout is a treatable disease. If it can be diagnosed and treated properly , gout can go away completely,” says rheumtologist Alan Baer, MD, professor of medicine and director of the rheumatology clinic at Johns Hopkins Medicine.

Symptoms
Gout: Abrupt onset of a red, hot, swollen, painful joint, most often in big toe, but less frequently in the foot, ankle, knee, wrist, elbow or finger; usually confined to just one joint in early disease.
CPPD: Abrupt onset of a red, hot, swollen, painful joint, most often knee, wrist or ankle; sometimes in spinal ligaments, causing neck pain; may affect one or more joints.

Causes
Gout: High uric acid levels cause monosodium urate crystals to form in and around the joint, resulting in inflammation and joint damage.
CPPD: CPPD crystals build up in cartilage, triggering inflammation and pain. Age and genes are risk factors. Other conditions may play a role.

Diagnosis
Gout: Medical history, physical exam, blood tests, joint fluid aspiration and analysis, X-ray, ultrasound, CT scan.
CPPD: Same, except CT scan is not done.

Treatment
Gout: For acute attack/flare: NSAIDs , corticosteroids , colchicine . For disease management: Dietary changes and uric-acid lowering drugs to prevent attacks.
CPPD: For acute attack/flare: NSAIDs, corticosteroids, colchicine.