Pseudogout (CPPD)
Expert diagnosis and personalized treatment at Arthritis Care of Los Angeles.
What is Pseudogout (CPPD)?
Pseudogout, also known as calcium pyrophosphate deposition disease (CPPD), is a form of inflammatory arthritis caused by the accumulation of calcium pyrophosphate dihydrate crystals in the joints. These crystals trigger episodes of sudden, severe joint pain and swelling that can closely mimic gout — hence the name "pseudogout." While gout is caused by uric acid crystals, pseudogout is caused by an entirely different type of crystal, and the two conditions require different approaches to treatment. Pseudogout most commonly affects the knees but can also involve the wrists, ankles, elbows, and shoulders. Acute attacks can last days to weeks and may be triggered by illness, surgery, or joint injury. In addition to acute flares, CPPD can cause chronic joint inflammation that resembles osteoarthritis or rheumatoid arthritis, making accurate diagnosis essential. Dr. Forouzesh at Arthritis Care of Los Angeles provides expert evaluation and management of pseudogout and CPPD at both our Culver City and Encino locations. Through precise crystal identification and individualized treatment plans, Dr. Forouzesh helps patients manage acute flares and reduce the frequency of future episodes.
Common Symptoms
- Sudden, severe joint pain — often in the knee, wrist, or ankle
- Significant swelling, warmth, and redness in the affected joint
- Episodes that can last days to several weeks
- Stiffness and reduced range of motion during flares
- Chronic joint pain resembling osteoarthritis between acute attacks
- Multiple joints affected simultaneously in some patients
- Low-grade fever during acute episodes
- Joint damage and deformity in long-standing cases
Experiencing these symptoms? Get expert care today.
How is Pseudogout (CPPD) Diagnosed?
The definitive diagnosis of pseudogout is made by identifying calcium pyrophosphate crystals in joint fluid obtained through arthrocentesis (joint aspiration). Under polarized light microscopy, these crystals appear as weakly positive birefringent rhomboid-shaped crystals, distinguishing them from the negatively birefringent needle-shaped uric acid crystals of gout. Dr. Forouzesh performs joint aspiration and fluid analysis to confirm the diagnosis. X-rays often reveal chondrocalcinosis — calcification of the cartilage — which is a hallmark finding in CPPD. Blood tests may be ordered to check for underlying metabolic conditions that can contribute to pseudogout, including hyperparathyroidism, hemochromatosis, and hypomagnesemia.
Treatment Options
Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)
NSAIDs are commonly used to manage acute pseudogout flares, reducing pain and inflammation. They are most effective when started early in an attack.
Colchicine
Low-dose colchicine can be used to treat acute flares and may also be prescribed as a daily preventive medication to reduce the frequency of attacks.
Corticosteroid Injections
Direct injection of corticosteroids into the affected joint provides rapid relief during severe acute flares, especially when NSAIDs are not well tolerated.
Oral Corticosteroids
Short courses of oral prednisone may be used for patients who cannot take NSAIDs or colchicine, or when multiple joints are involved simultaneously.
Joint Aspiration
Removing excess fluid from a swollen joint provides both diagnostic information and immediate symptom relief by reducing pressure and inflammation.
Treatment of Underlying Conditions
Addressing metabolic disorders such as hyperparathyroidism or hemochromatosis that may contribute to calcium pyrophosphate crystal formation.
Key Statistics
~3%
Of people in their 60s affected by CPPD
Source: Arthritis Foundation
~50%
Of people in their 90s have CPPD on X-ray
Source: American College of Rheumatology
#2
Second most common crystal arthropathy after gout
Source: Annals of the Rheumatic Diseases
Frequently Asked Questions
Ready to Get Expert Care?
Schedule your appointment with Dr. Solomon Forouzesh, MD, FACP, FACR — a board-certified rheumatologist with 50++ years of expertise in arthritis and autoimmune diseases.