Materiały źródłowe

• #1

  https://arthritis.ca/about-arthritis/arthritis-types-(a-z)/types/pseudogout

  Pseudogout is known as the great mimic and can mirror the symptoms of other inflammatory conditions such as gout (hence its name) and rheumatoid arthritis (RA). […] Unlike gout, which is caused by monosodium urate (MSU) crystals and effectively managed with urate-lowering drugs, there are no anti-crystal agents for pseudogout/CPPD. Therefore, episodes of pseudogout tend to be managed on a symptomatic basis. […] There are a wide range of therapies and treatments available for treating pseudogout. Colchicine is used to treat both gout and pseudogout. Research has shown that this medication can prevent inflammation and pain by blocking the interaction between CPPD in the joints and the immune system. […] Conventional anti-inflammatory medications such as non-steroidal anti-inflammatory drugs (NSAIDs) and corticosteroids are also used in the treatment of pseudogout.

• #2 Patient education: Calcium pyrophosphate crystal deposition (CPPD) disease (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/calcium-pyrophosphate-crystal-deposition-cppd-disease-beyond-the-basics

  CPPD DISEASE TREATMENT […] There is no treatment that can completely remove or prevent the formation of calcium pyrophosphate (CPP) dihydrate crystals. However, the joint pain and swelling generally resolve with treatment. Treatments vary depending on the type of calcium pyrophosphate crystal deposition (CPPD) disease but may including the following: […] Joint immobilization – Patients with a flare of acute CPP crystal arthritis may be advised to avoid weightbearing (walking or running if the legs or feet are involved), avoid excessive movement, and limit activity for a period of time to minimize pain and swelling. In some cases, a temporary splint will be recommended to limit joint movement. […] Joint aspiration and/or injection – Patients with acute CPP crystal arthritis affecting one or two joints may need a joint aspiration and/or injection. A clinician may insert a needle into the affected joint to remove the fluid and crystals that have accumulated. This can help to relieve pressure and pain. An injection of glucocorticoids (steroids) into the joint may relieve the associated joint inflammation.

• #3 Physical Therapy For Pseudogout | Capitol Physical Therapy | Physical Therapists in Washington DC

  https://capitolptdc.com/physical-therapy-for-pseudogout/

  Pseudogout can cause pain, swelling, and inflammation in joints like your knees, wrists, hips, ankles, and elbows. […] Working with an orthopedic physical therapist can help you identify and find relief for pseudogout. […] Physical therapy can provide relief from the pain, swelling, and loss of mobility that you experience with pseudogout. […] By working with a physical therapist, you may find significant relief from both acute and chronic pseudogout symptoms. […] RICE is also an effective at home treatment for joint pain, inflammation and swelling. […] Your physical therapist can show you a variety of exercises to preserve your range of motion and decrease stiffness and pain. […] Exercising in water is helpful for people with pseudogout because buoyancy prevents joint stress as you move. […] You can control swelling in its early stages by wrapping your joints. […] This forces the fluid away from your joint, preventing the pain, stiffness, and loss of mobility that can accompany edema.

• #4 Treatment and management of pseudogout: insights for the clinician

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3383522/

  The purpose of this article is to review current approaches that are used in the treatment of acute pseudogout and the management of chronic CPPD-related arthropathies, with a particular emphasis on the use of available agents to target the inflammasome, which plays a crucial role in crystal-induced inflammation and the theoretical potential of specific anticrystal therapies. […] Available and potential treatment options in the management of pseudogout are summarized in Table 1. Strategies that are currently employed in ameliorating CPPD-related joint disease are broadly limited to the following; those directed against correcting underlying metabolic abnormalities and treating associated conditions, general treatment with nonsteroidal anti-inflammatory drugs (NSAIDs) and/or corticosteroids (either by local intra-articular injection or systemic therapy), and finally, low-dose oral colchicine. Potential future therapies include agents targeted against crystal formation (such as probenecid and phosphocitrate), more potent anti-inflammatory medications such as methotrexate and anticytokine drugs which target the IL-1 pathway.

• #5 Pseudogout | ColumbiaDoctors

  https://www.columbiadoctors.org/treatments-conditions/pseudogout

  Though gout and pseudogout generally resolve on their own without treatment, they get better much more quickly with medication. […] It is important to make a clear diagnosis of pseudogout to allow for the best treatment plan. The right medication depends in part on the severity of your symptoms and in part on your other medical illnesses and other medications you take. […] There are 3 kinds of medicines that treat acute attacks of pseudogout. Nonsteroidal anti-inflammatory drugs such as ibuprofen or naproxen are effective. Colchicine can also bring the inflammation under control. Steroids, either by mouth or injected directly into the joint, are also highly effective. However, each of these medicines has its risks as well as its benefits, and treatment should be tailored to each individual patient. If a person has repeated attacks of pseudogout, the same medications can be used to prevent attacks as well.

• #6 Pseudogout – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/pseudogout/diagnosis-treatment/drc-20376988

  There’s no cure for pseudogout, but a combination of treatments can help relieve pain and improve the joint’s function. […] If over-the-counter pain relievers aren’t enough, your health care provider may suggest: […] Nonsteroidal anti-inflammatory drugs (NSAIDs). Prescription strength NSAIDs include naproxen (Naprosyn) and indomethacin (Indocin). NSAIDs can cause stomach bleeding and decreased kidney function, especially in older adults. […] Colchicine (Colcrys, Mitigare). Low-dose pills of this gout drug are also effective for pseudogout. If you have frequent episodes of pseudogout, you may be advised to take colchicine daily as a preventive measure. […] Corticosteroids. If you can’t take NSAIDs or colchicine, your health care provider may suggest taking corticosteroid pills, such as prednisone, to reduce inflammation and end the attack. Long-term use of corticosteroids can weaken bones and cause cataracts, diabetes and weight gain.

• #7 Calcium Pyrophosphate Deposition (CPPD) Disease Medication: Nonsteroidal Anti-Inflammatory Drugs (NSAIDs), Anti-Inflammatory Agents, Corticosteroids

  https://emedicine.medscape.com/article/330936-medication

  Nonsteroidal anti-inflammatory drugs (NSAIDs) or, occasionally, low-dose prednisone may be beneficial for chronic arthropathies due to calcium pyrophosphate deposition (CPPD) disease. Medical therapy for acute pseudogout is similar to that for gout, including the use of NSAIDs; intra-articular or, occasionally, systemic corticosteroids; and, rarely, oral or intravenous colchicine. […] Variable success in preventing acute attacks of pseudogout has been achieved with small doses of colchicine (0.6 mg once or twice daily) or NSAIDs. […] NSAIDs are very effective for the treatment of acute pseudogout and may be used for prophylaxis to prevent recurrent attacks of pseudogout. […] If given orally or, rarely, intravenously, these agents can be used to treat acute pseudogout. Toxicity is significant; therefore, other therapies should be considered first. Low-dose colchicine may be useful for long-term prophylaxis of pseudogout attacks.

• #8 Pseudogout (Chondrocalcinosis or CPPD): Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/pseudogout-chondrocalcinosis-cppd

  Pseudogout causes calcium pyrophosphate crystals to build up in your joints. A buildup of calcium pyrophosphate crystals in your joints can cause inflammation, pain, stiffness and swelling. […] Your provider will suggest treatments to manage the symptoms you’re experiencing and reduce how often you have pseudogout attacks. The most common treatments are medications, including: […] NSAIDs: Over-the-counter NSAIDs (nonsteroidal anti-inflammatory drugs) like ibuprofen or naproxen relieve pain and reduce inflammation. […] Corticosteroids: Corticosteroids are prescription anti-inflammatory medications. […] Colchicine: Colchicine is a prescription medication that reduces inflammation and pain. […] Biologic injections: Your provider may suggest anakinra or canakinumab injections to manage pseudogout attacks.

• #9 Calcium Pyrophosphate Deposition (CPPD) Disease Treatment & Management: Approach Considerations, Pharmacotherapy for Pseudogout

  https://emedicine.medscape.com/article/330936-treatment

  The use of NSAIDs can be considered, generally in higher doses during the acute attack and in lesser doses for prevention. […] Injection of corticosteroids such as 40-80 mg (depending on the size of the joint) of methylprednisolone or triamcinolone into the affected joint has the advantage of avoiding the adverse effects of systemic NSAIDs. […] Oral colchicine, or even intravenous (IV) colchicine, can be considered for the treatment of acute pseudogout. […] Anakinra has demonstrated efficacy in patients with recurrent acute CPP arthritis who have intolerance of, or inadequate response to, standard treatments.

• #10 Pseudogout – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/pseudogout/diagnosis-treatment/drc-20376988

  There’s no cure for pseudogout, but a combination of treatments can help relieve pain and improve the joint’s function. […] If over-the-counter pain relievers aren’t enough, your health care provider may suggest: […] Nonsteroidal anti-inflammatory drugs (NSAIDs). Prescription strength NSAIDs include naproxen (Naprosyn) and indomethacin (Indocin). NSAIDs can cause stomach bleeding and decreased kidney function, especially in older adults. […] Colchicine (Colcrys, Mitigare). Low-dose pills of this gout drug are also effective for pseudogout. If you have frequent episodes of pseudogout, you may be advised to take colchicine daily as a preventive measure. […] Corticosteroids. If you can’t take NSAIDs or colchicine, your health care provider may suggest taking corticosteroid pills, such as prednisone, to reduce inflammation and end the attack. Long-term use of corticosteroids can weaken bones and cause cataracts, diabetes and weight gain.

• #11 Treatment and management of pseudogout: insights for the clinician

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3383522/

  Colchicine acts upstream of the inflammasome and has an emerging role as a prophylactic agent. There is some evidence for its role in the prevention of both acute attacks of pseudogout and recurrent episodes of the other CPPD-related arthritides, and the recent mechanistic insights into its effects on crystal uptake into cells and inhibition of their subsequent interaction with the inflammasome have generated renewed interest in this medication as a potential anchor drug in the prophylaxis of pseudogout. […] Specific insights into the role of IL-1 in a variety of auto-inflammatory diseases have resulted in a number of case reports documenting the efficacy of anakinra, an IL-1 receptor antagonist, in difficult-to-treat polyarticular pseudogout. Furthermore, a newly developed monoclonal antibody to IL-1, canakinumab, has proven to be very effective in treating refractory cases of gouty arthritis, and a novel soluble fusion protein, IL-1 Trap, has recently been licensed for the treatment of several auto-inflammatory conditions.

• #12 Pseudogout – Symptoms and Treatment | familydoctor.org

  https://familydoctor.org/condition/pseudogout/

  Pseudogout treatment can relieve the symptoms of pseudogout and slow or prevent damage to your joints. Unfortunately, no treatment can get rid of the crystal deposits that cause pseudogout. Taking low doses of colchicine may help to reduce your risk of future attacks. Your doctor may suggest using a nonsteroidal anti-inflammatory drug (called an NSAID) to treat pain and swelling. These include ibuprofen (two brand names: Advil, Motrin) or naproxen (one brand name: Aleve). For severe attacks, your doctor may prescribe a prescription-strength NSAID such as indomethacin. If you can’t take NSAIDs, your doctor may prescribe a medicine called colchicine to reduce pain and swelling. […] If you have kidney problems or a history of stomach ulcers, you should not take anti-inflammatory medicines. You also should not take them if you are taking blood thinners. In these cases, the doctor may inject the affected joint with a shot of cortisone. Cortisone is a type of steroid that reduces pain and swelling.

• #13 Updated Treatment for Calcium Pyrophosphate Deposition Disease: An Insight

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6411330/

  Based on the clinical trials, it is recommended to treat the attacks of acute CPPD arthritis in the same way as true gout is treated. […] Anti-inflammatory drugs such as NSAIDs and glucocorticoids remain the mainstay of treatment. They can terminate on occasion acute attacks and relieve pain but cannot modify the course of the disease. Colchicine remains the conventional treatment for preventing recurrent episodes of acute flares. […] NSAIDs, notably ibuprofen and indomethacin, are given in low doses to suppress inflammation. […] Corticosteroids (CS) are the drug of choice in patients with contraindication to NSAIDs and colchicine. […] Colchicine (CL) has been proven to be a miracle in preventing acute flares. […] Certain patients fail to respond to the above-mentioned conventional drugs. Hence, some disease-modifying antirheumatic drugs (DMARDs) such as methotrexate and hydroxychloroquine and other medicines have been considered to treat refractory cases of CPPD arthritis on the basis of randomized controlled trials conducted on small scale.

• #14 Pseudogout – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/pseudogout/diagnosis-treatment/drc-20376988

  There’s no cure for pseudogout, but a combination of treatments can help relieve pain and improve the joint’s function. […] If over-the-counter pain relievers aren’t enough, your health care provider may suggest: […] Nonsteroidal anti-inflammatory drugs (NSAIDs). Prescription strength NSAIDs include naproxen (Naprosyn) and indomethacin (Indocin). NSAIDs can cause stomach bleeding and decreased kidney function, especially in older adults. […] Colchicine (Colcrys, Mitigare). Low-dose pills of this gout drug are also effective for pseudogout. If you have frequent episodes of pseudogout, you may be advised to take colchicine daily as a preventive measure. […] Corticosteroids. If you can’t take NSAIDs or colchicine, your health care provider may suggest taking corticosteroid pills, such as prednisone, to reduce inflammation and end the attack. Long-term use of corticosteroids can weaken bones and cause cataracts, diabetes and weight gain.

• #15 Calcium Pyrophosphate Deposition (CPPD) Disease Medication: Nonsteroidal Anti-Inflammatory Drugs (NSAIDs), Anti-Inflammatory Agents, Corticosteroids

  https://emedicine.medscape.com/article/330936-medication

  These agents are potent anti-inflammatories that are very useful in the treatment of acute pseudogout in patients who are not good candidates for NSAIDs; moreover, they are much less toxic than colchicine. Corticosteroids can be given orally, intravenously, or intra-articularly. Oral prednisone used for an acute attack of pseudogout is generally tapered over a 2-week period. Intra-articular corticosteroids (eg, methylprednisolone) are very effective for the treatment of acute pseudogout. […] Prednisone can be given orally to abort an attack of pseudogout. It can be given intravenously if the patient cannot take it by mouth. Intra-articular corticosteroids are the first choice of therapy due to their excellent safety profile. […] Anakinra is a possible alternative in the treatment and prevention of acute attacks of pseudogout in end-stage renal failure. […] Efficacy of anakinra in calcium pyrophosphate crystal-induced arthritis: a report of 16 cases and review of the literature. […] Efficacy of anakinra for refractory acute calcium pyrophosphate crystal arthritis.

• #16 Pseudogout Treatment

  https://www.arthritis-health.com/types/pseudogout-cppd/pseudogout-treatment

  The oral steroid prednisone may be prescribed if the patient cannot tolerate NSAIDs or colchicine. Long-term oral steroid treatment can have side effects. Oral steroids should not be taken with NSAIDs. […] Unlike conventional drugs that treat general inflammation after it has begun, interleukin-1 inhibitors can stop inflammation from happening. Interleukin-1 inhibitors are a type of biologic medication. They are typically taken via injection or infusion and are more costly than traditional medications. […] A doctor may prescribe a biologic only if other medications do not work or are not appropriate.

• #17 Pseudogout (Calcium Phyrophosphate Deposition Disease) – Cancer Therapy Advisor

  https://www.cancertherapyadvisor.com/home/decision-support-in-medicine/dermatology/pseudogout-calcium-phyrophosphate-deposition-disease/

  For mild attacks, NSAIDs are an alternative, but may take days to work. Antiinflammatory doses may carry significant risks in the elderly, particularly those with comorbidities such as a history of peptic ulcer disease, hypertension, congestive heart failure, renal insufficiency or hepatic insufficiency. Even among the healthy elderly, the risk of acute peptic ulcer disease increases dramatically in the eighth and ninth decades. […] If NSAIDs are used, they should be taken with food, and some thought should be given to use of one of the proton pump inhibitors (PPIs) that is FDA-approved for gastric ulcer prophylaxis in high risk users of NSAIDs. Not all PPIs are equally effective in this regard. Those PPIs so approved include lansoprazole and esomeprazole. […] For severe, polyarticular or recalcitrant attacks, systemic corticosteroids are indicated. Oral prednisone must be given at least twice a day to be reliably effective. Once-daily dosing is largely ineffective because of the short half-life of this agent. A dose of 30 mg twice a day or 20 mg three times a day normally suffices. Corticosteroids carry both short-term and long-term risks in the elderly. It is important to follow glucose and potassium levels closely. Occasionally significant fluid retention can occur, although this is not common with prednisone as compared with hydrocortisone. A few persons will develop corticosteroid-induced insomnia or psychosis. Osteoporosis, fragility fractures, cataracts, purpura and striae are all risks if used more than 2-3 weeks in the elderly.

• #18 Pseudogout – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/pseudogout/diagnosis-treatment/drc-20376988

  Removing some of the joint fluid can relieve pain and pressure in an affected joint. A needle is used to remove the fluid. The process also helps remove some of the crystals from the joint. The joint is then injected with a numbing medication and a corticosteroid to decrease inflammation. […] Home treatments may be useful during pseudogout flare-ups. Examples include: […] Over-the-counter NSAIDs, such as ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve), often are helpful. […] Try not to use the affected joint for a couple of days. […] Cold packs can help reduce the inflammation associated with flare-ups.

• #19 Pseudogout Treatment

  https://www.arthritis-health.com/types/pseudogout-cppd/pseudogout-treatment

  A doctor can aspirate a joint by inserting a needle into the affected joint and removing some of the fluid that has accumulated. Aspiration relieves pressure, making the patient more comfortable. […] A steroid injection to reduce inflammation one of the most common medical treatments to be recommended. This injection is typically done following an aspiration. […] If more than two joints are affected then corticosteroid injections are typically not advised. […] If a corticosteroid injection is not appropriate or ineffective, a prescription drug called colchicine may be prescribed to treat a pseudogout attack. […] People who have multiple pseudogout attacks may be advised to take a small daily dose of colchicine to prevent attacks from occurring. […] An over-the-counter or prescription-strength NSAID, such as ibuprofen and naproxen, can be used to relieve pseudogout pain.

• #20 Pseudogout – Symptoms and Treatment | familydoctor.org

  https://familydoctor.org/condition/pseudogout/

  Your doctor may drain fluid from your joint to relieve your symptoms. This method is called joint aspiration. It is often used along with cortisone shots. […] Your doctor may recommend that you limit physical activity while you are having symptoms of a pseudogout attack. […] If your joints become badly damaged by pseudogout, surgery may be necessary to repair or replace them.

• #21 Acute CPP crystal arthritis | Symptoms, causes

  https://versusarthritis.org/about-arthritis/conditions/acute-cpp-crystal-arthritis/

  Symptoms of acute CPP crystal arthritis usually settle on their own after a time. But because it can be very painful, you can get treatment to help ease the pain and reduce the inflammation. […] Your doctor may use a needle and syringe to take extra fluid out of the joint to reduce the swelling and ease pressure in the joint that can cause pain. […] This procedure is fairly simple and quick, and it usually brings fast relief. Your doctor will numb the area first so it isn’t too painful. […] The excess fluid that’s been removed can be examined under a microscope to check for calcium crystals. […] Once the excess fluid has been drawn out, your doctor will usually inject a small amount of a steroid into the joint through the same needle. This helps to reduce inflammation in the lining of your joint and prevent the build-up of more fluid.

• #22 Treatment and management of pseudogout: insights for the clinician

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3383522/

  Colchicine acts upstream of the inflammasome and has an emerging role as a prophylactic agent. There is some evidence for its role in the prevention of both acute attacks of pseudogout and recurrent episodes of the other CPPD-related arthritides, and the recent mechanistic insights into its effects on crystal uptake into cells and inhibition of their subsequent interaction with the inflammasome have generated renewed interest in this medication as a potential anchor drug in the prophylaxis of pseudogout. […] Specific insights into the role of IL-1 in a variety of auto-inflammatory diseases have resulted in a number of case reports documenting the efficacy of anakinra, an IL-1 receptor antagonist, in difficult-to-treat polyarticular pseudogout. Furthermore, a newly developed monoclonal antibody to IL-1, canakinumab, has proven to be very effective in treating refractory cases of gouty arthritis, and a novel soluble fusion protein, IL-1 Trap, has recently been licensed for the treatment of several auto-inflammatory conditions.

• #23 Pseudogout Treatment

  https://www.arthritis-health.com/types/pseudogout-cppd/pseudogout-treatment

  The oral steroid prednisone may be prescribed if the patient cannot tolerate NSAIDs or colchicine. Long-term oral steroid treatment can have side effects. Oral steroids should not be taken with NSAIDs. […] Unlike conventional drugs that treat general inflammation after it has begun, interleukin-1 inhibitors can stop inflammation from happening. Interleukin-1 inhibitors are a type of biologic medication. They are typically taken via injection or infusion and are more costly than traditional medications. […] A doctor may prescribe a biologic only if other medications do not work or are not appropriate.

• #24 Patient education: Calcium pyrophosphate crystal deposition (CPPD) disease (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/calcium-pyrophosphate-crystal-deposition-cppd-disease-beyond-the-basics

  Oral antiinflammatory medications – Oral antiinflammatory medications, such as a nonsteroidal antiinflammatory drug (NSAID), an oral glucocorticoid, or colchicine, may be preferred over joint injections for treating attacks of acute CPP crystal arthritis that affect more than two joints. They are usually continued until the attack resolves. In addition, oral antiinflammatory medications are sometimes used to try to prevent attacks of acute CPP crystal arthritis and for treating chronic CPP crystal inflammatory arthritis. […] Immunosuppressive medications – Sometimes patients with acute or chronic CPP crystal arthritis may need medications that help calm down the immune system and reduce inflammation. As an example, providers may prescribe medications like anakinra or canakinumab for a patient with a bad flare of acute CPP crystal arthritis if the patient cannot take or does not respond to other options. […] Treatment of related conditions – If CPPD is caused by a separate disorder, that condition may require treatment, although this may not affect the course of CPP crystal-related joint disease.

• #25 Newly developed pseudogout arthritis after therapy with MAGE-A4 directed TCR T cells responded to treatment with tocilizumab | Journal for ImmunoTherapy of Cancer

  https://jitc.bmj.com/content/9/7/e002716

  Now, we report a case of pseudogout arthritis in a patient treated with MAGE-A4 directed T cell receptor T cells, for fallopian tube cancer. […] Notably, the pseudogout arthritis was resolved with tocilizumab, which was administered for the treatment of CRS and ICANS. […] Interestingly, tocilizumab, which was used to treat the CRS and ICANS, also worked for the pseudogout arthritis. […] Our clinical observation is particularly important as steroids, the first-line therapy for pseudogout arthritis, are frequently avoided for the treatment of IEC-associated toxicities due to their potential lymphocytolytic activity. […] This is the first case reporting pseudogout arthritis in a patient who developed CRS and ICANS after T cell therapy. Importantly, pseudogout arthritis of our patient was resolved with tocilizumab.

• #26 Calcium Pyrophosphate Deposition (Pseudogout)

  https://patient.info/doctor/calcium-pyrophosphate-deposition-including-pseudogout-pro

  Chronic CPP crystal arthritis is much more difficult to manage than acute CPP crystal arthritis: For patients with monoarticular or oligoarticular large-joint involvement, repeated intra-articular injections of glucocorticoids may control symptoms. No current disease-modifying drugs are available for CPPD disease. The daily use of oral colchicine at a low dose may be useful in reducing the frequency of acute attacks. Alternatively, NSAIDs may produce similar beneficial effects if that they do not cause side-effects. Low-dose systemic glucocorticoids may be necessary to control pain and inflammation if colchicine or NSAIDs are ineffective or associated with unacceptable side-effects.

• #27 Pseudogout (Calcium Pyrophosphate Deposition)

  https://patient.info/bones-joints-muscles/calcium-pyrophosphate-deposition-pseudogout

  Unlike gout, there is no special treatment for pseudogout. Rest, ice packs and anti-inflammatory medicines are the main forms of treatment. […] Ice packs and rest may be helpful. Painkillers and anti-inflammatory medicines are usually given to help the pain and inflammation. Other treatments sometimes tried include draining any fluid with a syringe and needle, injecting steroid liquid into the joint and taking steroid tablets. […] Pseudogout cannot be cured but treatment is available to relieve the symptoms until the attack settles. […] Chronic CPP crystal arthritis is usually treated in the same way as pseudogout, with painkillers and anti-inflammatory medicines. Other medicines that have been tried are called methotrexate and hydroxychloroquine. […] Colchicine, often used in the treatment of gout, is also sometimes helpful in pseudogout management. In pseudogout, colchicine has been found to reduce inflammation and slow the production of CPP crystals. It can therefore be used as a treatment for an acute attack of pseudogout and as a preventative treatment in people who have frequent attacks.

• #28 Calcium Pyrophosphate Deposition (CPPD) Disease Treatment & Management: Approach Considerations, Pharmacotherapy for Pseudogout

  https://emedicine.medscape.com/article/330936-treatment

  Hydroxychloroquine can be used as adjuvant therapy to prevent flareups. […] Methotrexate has proved effective in small numbers of patients with severe disease, especially those with joint destruction. […] Studies have indicated that activation of IL-1 by the inflammasome complex plays a pivotal role in pseudogout attacks, which suggested the IL-1 receptor antagonist anakinra (Kineret) as a potential alternative for treating patients with CPPD. […] Finally, a theoretical possibility for pharmacologic treatment of CPPD is the use of anticrystal agents to prevent deposition of calcium pyrophosphate dihydrate. […] Radiosynovectomy is a minimally invasive technique that involves the intra-articular injection of small radioactive particles to remove inflamed synovium. […] Patients with pseudoneuropathic arthropathy that is refractory to medical management may benefit from surgical replacement of the damaged joint with a bioprosthesis.

• #29 Pseudogout (CPPD) Guide: Causes, Symptoms and Treatment Options

  https://www.drugs.com/health-guide/pseudogout-cppd.html

  You may also need to take oral corticosteroids for a short time. Your doctor may prescribe a medicine called colchicine or an NSAID to prevent attacks. For people with frequent attacks or chronic joint inflammation due to pseudogout despite treatments mentioned, other medications to reduce inflammation may be recommended such as hydroxychloroquine or methotrexate. If other treatments aren’t effective, newer medications such as anakinra or tocilizumab may be recommended. […] Occasionally, people with recurrent or chronic pseudogout may develop degenerative joint disease. In this case, surgery (such as joint replacement) may become the only effective treatment. […] With treatment, the outlook for pseudogout is usually good. Joint pain and swelling usually go away promptly. It’s common for attacks to return, but usually they can be controlled with repeated treatment.

• #30 Pseudogout – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/pseudogout/diagnosis-treatment/drc-20376988

  Removing some of the joint fluid can relieve pain and pressure in an affected joint. A needle is used to remove the fluid. The process also helps remove some of the crystals from the joint. The joint is then injected with a numbing medication and a corticosteroid to decrease inflammation. […] Home treatments may be useful during pseudogout flare-ups. Examples include: […] Over-the-counter NSAIDs, such as ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve), often are helpful. […] Try not to use the affected joint for a couple of days. […] Cold packs can help reduce the inflammation associated with flare-ups.

• #31 Physical Therapy For Pseudogout | Capitol Physical Therapy | Physical Therapists in Washington DC

  https://capitolptdc.com/physical-therapy-for-pseudogout/

  Pseudogout can cause pain, swelling, and inflammation in joints like your knees, wrists, hips, ankles, and elbows. […] Working with an orthopedic physical therapist can help you identify and find relief for pseudogout. […] Physical therapy can provide relief from the pain, swelling, and loss of mobility that you experience with pseudogout. […] By working with a physical therapist, you may find significant relief from both acute and chronic pseudogout symptoms. […] RICE is also an effective at home treatment for joint pain, inflammation and swelling. […] Your physical therapist can show you a variety of exercises to preserve your range of motion and decrease stiffness and pain. […] Exercising in water is helpful for people with pseudogout because buoyancy prevents joint stress as you move. […] You can control swelling in its early stages by wrapping your joints. […] This forces the fluid away from your joint, preventing the pain, stiffness, and loss of mobility that can accompany edema.

• #32 Patient education: Calcium pyrophosphate crystal deposition (CPPD) disease (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/calcium-pyrophosphate-crystal-deposition-cppd-disease-beyond-the-basics

  CPPD DISEASE TREATMENT […] There is no treatment that can completely remove or prevent the formation of calcium pyrophosphate (CPP) dihydrate crystals. However, the joint pain and swelling generally resolve with treatment. Treatments vary depending on the type of calcium pyrophosphate crystal deposition (CPPD) disease but may including the following: […] Joint immobilization – Patients with a flare of acute CPP crystal arthritis may be advised to avoid weightbearing (walking or running if the legs or feet are involved), avoid excessive movement, and limit activity for a period of time to minimize pain and swelling. In some cases, a temporary splint will be recommended to limit joint movement. […] Joint aspiration and/or injection – Patients with acute CPP crystal arthritis affecting one or two joints may need a joint aspiration and/or injection. A clinician may insert a needle into the affected joint to remove the fluid and crystals that have accumulated. This can help to relieve pressure and pain. An injection of glucocorticoids (steroids) into the joint may relieve the associated joint inflammation.

• #33 How Does Physical Therapy Help Manage Pseudogout? — Best Bainbridge Island Physical Therapy Clinic For Pain Relief, Injury Prevention & Rehabilitation

  https://fiziologix.com/blog-fiziologix-physical-therapy-tips-and-self-healing/8/13/2023/how-does-physical-therapy-helps-manage-pseudogout

  Education: Physical therapists can provide education about joint protection techniques, proper body mechanics, and lifestyle modifications to minimize joint stress and prevent exacerbation of pseudogout symptoms. […] Assistive Devices: Depending on the severity of the condition, physical therapists may recommend the use of assistive devices such as braces, splints, or walking aids to provide additional support to affected joints. […] Individualized Treatment: Physical therapy plans are tailored to each individual’s specific needs, taking into consideration the location and severity of pseudogout symptoms, as well as the person’s overall health and activity level. […] It’s important to note that physical therapy is just one component of a comprehensive treatment plan for pseudogout. Medical interventions, such as medications to manage inflammation and pain, are typically prescribed by a rheumatologist or other medical professional.

• #34 Pseudogout Treatment

  https://www.arthritis-health.com/types/pseudogout-cppd/pseudogout-treatment

  The recommended treatments for pseudogout focus on reducing joint inflammation and pain. In addition to alleviating symptoms, treatment can help minimize the risk of long-term joint damage associated with repeated episodes of pseudogout. […] Common treatment recommendations for pseudogout as well as another CPPD disease called chronic CPP arthritis are described below. […] To alleviate sudden, severe pseudogout pain, a health care provider may recommend: […] A cool compress applied to the affected joint can help relieve discomfort and decrease swelling. […] It is usually painful to use the affected joint. Resting it for a day or two can help alleviate inflammation, pain, swelling, and other symptoms. […] If possible, elevating the affected limb can help help reduce swelling. If the knee is affected, sitting down with the foot resting on a footstool or lying down with the foot propped up on a pillow may provide symptom relief.

• #35 Pseudogout: Joint Pain, Gout Differences, Treatment

  https://www.verywellhealth.com/pseudogout-8603574

  How to Manage Pseudogout Flares […] You can manage a pseudogout flare at home. This includes over-the-counter NSAIDs, such as ibuprofen and naproxen sodium, to help manage pain and reduce inflammation. […] […] Additional ways to manage flare symptoms and ease discomfort include: […] Using cold compresses against the affected joint to relieve discomfort and swelling […] Resting the affected joint and using it as little as possible […] Elevating the affected joint by lying down or placing a pillow underneath […] Contact a healthcare provider if at-home treatments do not help or symptoms worsen. They can prescribe a more potent NSAID or a corticosteroid to help manage symptoms. […] […] You should also inform a healthcare provider if you experience frequent or severe flares. They can prescribe medications to prevent crystal build-up or control underlying processes that might lead to inflammation.

• #36 Physical Therapy For Pseudogout | Capitol Physical Therapy | Physical Therapists in Washington DC

  https://capitolptdc.com/physical-therapy-for-pseudogout/

  Pseudogout can cause pain, swelling, and inflammation in joints like your knees, wrists, hips, ankles, and elbows. […] Working with an orthopedic physical therapist can help you identify and find relief for pseudogout. […] Physical therapy can provide relief from the pain, swelling, and loss of mobility that you experience with pseudogout. […] By working with a physical therapist, you may find significant relief from both acute and chronic pseudogout symptoms. […] RICE is also an effective at home treatment for joint pain, inflammation and swelling. […] Your physical therapist can show you a variety of exercises to preserve your range of motion and decrease stiffness and pain. […] Exercising in water is helpful for people with pseudogout because buoyancy prevents joint stress as you move. […] You can control swelling in its early stages by wrapping your joints. […] This forces the fluid away from your joint, preventing the pain, stiffness, and loss of mobility that can accompany edema.

• #37 How Does Physical Therapy Help Manage Pseudogout? — Best Bainbridge Island Physical Therapy Clinic For Pain Relief, Injury Prevention & Rehabilitation

  https://fiziologix.com/blog-fiziologix-physical-therapy-tips-and-self-healing/8/13/2023/how-does-physical-therapy-helps-manage-pseudogout

  Physical therapy can play a beneficial role in managing the symptoms of pseudogout. Pseudogout is a form of arthritis that is caused by the accumulation of calcium pyrophosphate crystals in the joints, leading to inflammation and pain. While physical therapy cannot directly treat the underlying cause of pseudogout, it can help alleviate pain, improve joint mobility, and enhance overall function. Here’s how physical therapy can assist in managing pseudogout: […] Pain Management: Physical therapists can employ various modalities such as heat, ice, ultrasound, and electrical stimulation to help reduce pain and inflammation in affected joints. These techniques can provide temporary relief from discomfort. […] Joint Mobility: Pseudogout can lead to stiffness and reduced range of motion in affected joints. Physical therapists can design exercises and stretches to improve joint flexibility and mobility. Gentle, controlled movements can help prevent joint stiffness and maintain function.

• #38 How Does Physical Therapy Help Manage Pseudogout? — Best Bainbridge Island Physical Therapy Clinic For Pain Relief, Injury Prevention & Rehabilitation

  https://fiziologix.com/blog-fiziologix-physical-therapy-tips-and-self-healing/8/13/2023/how-does-physical-therapy-helps-manage-pseudogout

  Muscle Strengthening: Strengthening the muscles around affected joints is important for providing stability and support. Physical therapists can develop targeted exercises to strengthen muscles, which can help alleviate stress on the joints and improve overall joint function. […] Balance and Coordination: Pseudogout can affect balance and coordination, increasing the risk of falls. Physical therapists can design balance and coordination exercises to enhance stability and reduce the likelihood of accidents. […] Gait Training: If pseudogout affects weight-bearing joints such as the knees or hips, it can impact a person’s gait (walking pattern). Physical therapists can assess and correct any abnormal walking patterns through gait training exercises, which can help improve movement and reduce strain on the affected joints.

• #39

  https://arthritis.ca/about-arthritis/arthritis-types-(a-z)/types/pseudogout

  Corticosteroids may also be effective in controlling the inflammatory flares associated with pseudogout. […] For patients who cannot take steroids, NSAIDS, or colchicine, there is some evidence for the biologic agent anakinra, which blocks the major inflammatory cell messenger involved in pseudogout (namely interleukin 1/IL1), but this is reserved for severe cases and is an ongoing area of research. […] Regular low-impact exercise is an essential component of self-management for pseudogout. […] A common misconception is that a painful joint requires rest. On the contrary, lack of movement can cause muscle weakness and worsen joint pain and stiffness. […] Therapeutic exercises improve connections and response time between your brain and your muscles, increasing coordination to help the joint remain stable during physical activity and reduce risk of injury.

• #40 Pseudogout – Symptoms and Treatment | familydoctor.org

  https://familydoctor.org/condition/pseudogout/

  Your doctor may drain fluid from your joint to relieve your symptoms. This method is called joint aspiration. It is often used along with cortisone shots. […] Your doctor may recommend that you limit physical activity while you are having symptoms of a pseudogout attack. […] If your joints become badly damaged by pseudogout, surgery may be necessary to repair or replace them.

• #41 Pseudogout: Gout, Causes, Treatment, Prevention, and More

  https://www.healthline.com/health/pseudogout

  Theres currently no treatment available to get rid of the crystal deposits. […] Your doctor may drain the synovial fluid from the joint to relieve the pressure within the joint and reduce inflammation. […] To help with acute attacks, your doctor may prescribe nonsteroidal anti-inflammatory drugs (NSAIDs) to reduce the swelling and relieve the pain. […] To help reduce the risk of additional flare-ups, your doctor may prescribe low doses of colchicine (Colcrys) or NSAIDs. […] Other medications used to treat pseudogout include: hydroxychloroquine (Plaquenil, Quineprox) and methotrexate (Rheumatrex, Trexall). […] If your joints are wearing out, your doctor may recommend surgery to repair or replace them. […] While you cant prevent the disease, you can find treatments to reduce the inflammation and relieve the pain. Treating the underlying condition that causes pseudogout may slow its development and lessen the severity of symptoms.

• #42 Calcium Pyrophosphate Deposition (CPPD) Disease Treatment & Management: Approach Considerations, Pharmacotherapy for Pseudogout

  https://emedicine.medscape.com/article/330936-treatment

  Hydroxychloroquine can be used as adjuvant therapy to prevent flareups. […] Methotrexate has proved effective in small numbers of patients with severe disease, especially those with joint destruction. […] Studies have indicated that activation of IL-1 by the inflammasome complex plays a pivotal role in pseudogout attacks, which suggested the IL-1 receptor antagonist anakinra (Kineret) as a potential alternative for treating patients with CPPD. […] Finally, a theoretical possibility for pharmacologic treatment of CPPD is the use of anticrystal agents to prevent deposition of calcium pyrophosphate dihydrate. […] Radiosynovectomy is a minimally invasive technique that involves the intra-articular injection of small radioactive particles to remove inflamed synovium. […] Patients with pseudoneuropathic arthropathy that is refractory to medical management may benefit from surgical replacement of the damaged joint with a bioprosthesis.

• #43 Calcium Pyrophosphate Deposition | Arthritis Foundation

  https://www.arthritis.org/diseases/calcium-pyrophosphate-deposition

  Pseudogout comes on suddenly and causes intense pain in one or more joints. […] Theres no treatment available to dissolve the crystal deposits, but a combination of treatments can relieve pain and inflammation and improve joint function. Treatment often includes medications such nonsteroidal anti-inflammatory drugs (NSAIDs) or corticosteroids. […] In severe cases, surgery to replace damaged joints is an option. […] In addition to taking prescribed treatments, it is important to rest painful joints. Ice packs can help reduce the pain and inflammation associated with flares. Excess weight increases inflammation in the body, so its important to maintain a healthy weight with exercise and healthy, balanced nutrition.

• #44 Treatment of calcium pyrophosphate crystal deposition (CPPD) disease – UpToDate

  https://www.uptodate.com/contents/treatment-of-calcium-pyrophosphate-crystal-deposition-cppd-disease

  Treatment of calcium pyrophosphate crystal deposition (CPPD) disease […] Treatment of acute episodes consists of supportive measures as well as intraarticular or systemic antiinflammatory therapy. The choice of antiinflammatory therapy is based upon factors such as the patient’s clinical presentation (eg, number of joints) as well as the potential adverse effects of each agent. Prophylaxis against acute flares may be indicated for patients with frequent episodes (≥3 episodes/year). […] The approach to treatment of calcium pyrophosphate crystal deposition (CPPD) disease depends on the subtype, which is based on clinical manifestations and acuity. Asymptomatic patients who have evidence of cartilage calcification (also called chondrocalcinosis) on imaging do not need any specific treatment.

• #45 Calcium Pyrophosphate Deposition (CPPD) Disease Medication: Nonsteroidal Anti-Inflammatory Drugs (NSAIDs), Anti-Inflammatory Agents, Corticosteroids

  https://emedicine.medscape.com/article/330936-medication

  Nonsteroidal anti-inflammatory drugs (NSAIDs) or, occasionally, low-dose prednisone may be beneficial for chronic arthropathies due to calcium pyrophosphate deposition (CPPD) disease. Medical therapy for acute pseudogout is similar to that for gout, including the use of NSAIDs; intra-articular or, occasionally, systemic corticosteroids; and, rarely, oral or intravenous colchicine. […] Variable success in preventing acute attacks of pseudogout has been achieved with small doses of colchicine (0.6 mg once or twice daily) or NSAIDs. […] NSAIDs are very effective for the treatment of acute pseudogout and may be used for prophylaxis to prevent recurrent attacks of pseudogout. […] If given orally or, rarely, intravenously, these agents can be used to treat acute pseudogout. Toxicity is significant; therefore, other therapies should be considered first. Low-dose colchicine may be useful for long-term prophylaxis of pseudogout attacks.

• #46 Calcium Pyrophosphate Deposition (Pseudogout)

  https://patient.info/doctor/calcium-pyrophosphate-deposition-including-pseudogout-pro

  Chronic CPP crystal arthritis is much more difficult to manage than acute CPP crystal arthritis: For patients with monoarticular or oligoarticular large-joint involvement, repeated intra-articular injections of glucocorticoids may control symptoms. No current disease-modifying drugs are available for CPPD disease. The daily use of oral colchicine at a low dose may be useful in reducing the frequency of acute attacks. Alternatively, NSAIDs may produce similar beneficial effects if that they do not cause side-effects. Low-dose systemic glucocorticoids may be necessary to control pain and inflammation if colchicine or NSAIDs are ineffective or associated with unacceptable side-effects.

• #47

  https://bpac.org.nz/bpj/2013/october/cppd.aspx

  Treatments to reduce the pain and swelling associated with an acute attack of CPPD disease include: Ice or cool packs, Temporary rest of the affected joint, Joint aspiration, Oral NSAIDs, Low dose colchicine, Corticosteroids (intra-articular injection or oral). […] If NSAIDs or colchicine are unable to be used, a short tapering course of oral corticosteroids (e.g. prednisone 0.5 mg/kg, daily, with a rapid taper) may also provide relief from acute symptoms, especially in patients with severe polyarticular attacks. […] The choice of medicines used for patients with chronic CPPD is based primarily on evidence for treatments used to manage gout and osteoarthritis, and on expert opinion. The following treatments may be trialled as appropriate (in order of preference), in patients with chronic CPPD disease: NSAIDs (with PPI protection), Low dose colchicine, e.g. 0.5 1 mg daily, Low dose oral corticosteroids no specific dose recommendation given; usual maintenance dose is between 2.5 mg 15 mg daily. […] There is some evidence that low dose colchicine (0.5 mg, once or twice daily) may be effective in reducing the number of attacks in patients with frequent recurrent episodes, but no evidence on the use of NSAIDs.

• #48 Treatment and management of pseudogout: insights for the clinician

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3383522/

  The use of regular colchicine as a prophylactic agent against acute attacks of pseudogout will probably become more widespread. Similarly, drugs targeting the IL-1 pathway offer considerable potential in severe refractory disease. However, in contrast to MSU crystals in gout, there is no practical way to remove CPPD crystals from the joint. Therefore, current management strategies remain symptomatic but not disease modifying. Further research into ways of reducing the CPPD crystal burden is very necessary.

• #49 Updated Treatment for Calcium Pyrophosphate Deposition Disease: An Insight

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6411330/

  Interleukin-1 receptor antagonists, namely anakinra, are recombinant genetically modified biopharmaceutical drugs that competitively bind to the interleukin-1 receptor, preventing the action of interleukin-1, a very prominent cytokine in the pathway of inflammation; thus halting the assembly of an inflammasome complex. […] Theoretically, any pharmacological or surgical approach that works to inhibit the origination of CPP crystals or promotes the dissolution of crystals can cure CPPD arthropathies; hence, more research is required in this area to explore better interventions. […] The availability of high levels of free inorganic phosphate in the extracellular matrix of chondrocytes seem to lay the foundation of calcium crystals, therefore using pharmacological agents that can lower the free phosphate levels such as probenecid, phosphocitrate (PC) and polyphosphate (polyP) can prevent CPP crystal formation. […] CPPD is an umbrella term encompassing all the various clinical subsets of CPP crystal-related arthropathies. NSAIDs, CSs and COL still remain the standard drugs to treat acute pseudo-gout; but unfortunately, they have been observed to be less successful in treating chronic cases.

• #50 Calcium pyrophosphate dihydrate crystal deposition disease – Wikipedia

  https://en.wikipedia.org/wiki/Calcium_pyrophosphate_dihydrate_crystal_deposition_disease

  Because any medication that could reduce the inflammation of CPPD bears a risk of causing organ damage, treatment is not advised if the condition is not causing pain. For acute pseudogout, treatments include intra-articular corticosteroid injection, systemic corticosteroids, non-steroidal anti-inflammatory drugs (NSAIDs), or, on occasion, high-dose colchicine. In general, NSAIDs are administered in low doses to help prevent CPPD. However, if an acute attack is already occurring, higher doses are administered. If nothing else works, hydroxychloroquine or methotrexate may provide relief. Research into surgical removal of calcifications is underway, however, this still remains an experimental procedure. […] NSAIDs, Colchicine, and methotrexate may provide initial relief. There is currently no treatment for non-invasive removal of these crystals once they are deposited. Attempts to dissolve crystals in situ using enzymes turned up to be a „clinical failure”. New, innovative methods using catalytic peptides are in development.

• #51 Stem Cells for Pseudogout | New Jersey Sports Medicine

  https://www.njsportsmed.com/stem-cells-for-psuedogout-new-jersey-sports-medicine

  Can bone marrow aspirate stem cell injections be used in the treatment of pseudogout? […] „Unlike gout, the treatment of CPPD-related arthropathies can be difficult to the the lack of any effective agent to decrease crystal load” (Announ and Guerne, 2008). […] The patient came to Dr. Silberman for care looking for alternatives to cortisone and steroid injections taught to orthopedic surgeons and rheumatologists to be the primary treatment for pseudogout, gout, and inflammatory arthritis. […] After discussing prolotherapy, platelet rich plasma therapy (PRP), and bone marrow aspirate stem cell injections, the patient chose stem cell injections for the treatment of his pseudogout and calcium pryophosphate deposition disease (CPPD). […] This preliminary study, a case report with successful elimination of calcium crystals from a knee fluid analysis post bone marrow aspirate stem cell injection, points to a need for further research not just with bone marrow aspirate stem cells for pseudogout but with platelet rich plasma (PRP) and prolotherapy as well, as cortisone may be detrimental when repeated for this stubborn problematic condition and for other inflammatory conditions, such as rheumatoid arthritis (RA), lyme arthritis (lyme disease), psoriatic arthritis, and ankylosing arthritis (sacroiliac disease or AS), all of which have been treated by Dr. Silberman with platelet rich plasma (PRP) or bone marrow aspirate stem cell injections with encouraging clinical results.

• #52 Understanding Pseudogout: Treatment, Causes, and Relief for Joint Pain – Chicago Arthritis and Regenerative Medicine

  https://chicagoarthritis.com/understanding-pseudogout-treatment-causes-and-relief-for-joint-pain/

  Alongside traditional treatments, natural and lifestyle adjustments can play a vital role in managing pseudogout. […] Diet and Supplements: Low magnesium levels can promote crystal formation. Including magnesium-rich foods like spinach, almonds, and whole grains in your diet can help. Taking magnesium supplements may also be beneficial. […] Anti-inflammatory Foods: Consuming foods rich in omega-3s (like fish), turmeric, and antioxidant-packed fruits (such as blueberries) may help reduce joint inflammation. […] Hydration: Staying hydrated is crucial for joint lubrication and preventing crystal buildup. […] Exercise and Weight Management: Regular physical activity strengthens muscles around the joints, improves mobility, and reduces joint stress. Maintaining a healthy weight can lessen the strain on weight-bearing joints like the knees.

• #53

  https://arthritis.ca/about-arthritis/arthritis-types-(a-z)/types/pseudogout

  Corticosteroids may also be effective in controlling the inflammatory flares associated with pseudogout. […] For patients who cannot take steroids, NSAIDS, or colchicine, there is some evidence for the biologic agent anakinra, which blocks the major inflammatory cell messenger involved in pseudogout (namely interleukin 1/IL1), but this is reserved for severe cases and is an ongoing area of research. […] Regular low-impact exercise is an essential component of self-management for pseudogout. […] A common misconception is that a painful joint requires rest. On the contrary, lack of movement can cause muscle weakness and worsen joint pain and stiffness. […] Therapeutic exercises improve connections and response time between your brain and your muscles, increasing coordination to help the joint remain stable during physical activity and reduce risk of injury.

• #54 Pseudogout: Joint Pain, Gout Differences, Treatment

  https://www.verywellhealth.com/pseudogout-8603574

  Joint drainage may relieve pain and pressure on a pseudogout-affected joint. A needle is used to remove the fluid and some of the crystals. The joint is then injected with a numbing drug and a corticosteroid to reduce inflammation. […] […] If none of these medicines work, joint damage may occur. In these cases, surgery can repair and replace damaged joints. […] […] While diet has no role in forming crystals that lead to pseudogout, changing your diet to eliminate inflammation-producing foods might help. You will want to avoid sources of trans fat (i.e., margarine and polyunsaturated vegetable oils), junk foods, baked goods, refined sugars, and alcohol. […] […] Instead, add anti-inflammatory foods, including fatty fish, fruits, vegetables, spices (like turmeric), and olive oil, to your diet.

• #55 Pseudogout (Calcium Pyrophosphate Deposition)

  https://patient.info/bones-joints-muscles/calcium-pyrophosphate-deposition-pseudogout

  Unlike gout, no specific diet has been found to be helpful in pseudogout and there’s no link between pseudogout and alcohol. However, since lack of fluid (dehydration) is a trigger factor for CPP crystal deposition, it makes sense to keep up your fluid intake. […] Chronic CPP crystal arthritis affecting a large joint sometimes requires surgery. […] If an underlying condition caused an episode of pseudogout (eg, lack of fluid (dehydration) or low magnesium levels), treating this may prevent further attacks.

• #56 Treatment strategies for calcium pyrophosphate deposition disease

  https://www.explorationpub.com/Journals/emd/Article/100756

  Although CPPD can be idiopathic, some cases of CPPD may be associated with underlying disorders such as primary and secondary hyperparathyroidism, hypomagnesemia, hypophosphatasia, hemochromatosis, Gitelman syndrome, previous joint surgery, metabolic risk factors such as obesity and hypertension, and chronic gout. […] There is a clear need for randomized controlled trials to determine the most effective therapies for CPP crystal arthritis.

• #57 Pseudogout – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/pseudogout/symptoms-causes/syc-20376983

  It isn’t clear why crystals form in joints and cause pseudogout, but the risk increases with age. Treatments can help relieve pain and reduce inflammation. […] Pseudogout has also been linked to an underactive thyroid gland or an overactive parathyroid gland. […] The crystal deposits associated with pseudogout can also cause joint damage, which can mimic the signs and symptoms of osteoarthritis or rheumatoid arthritis.

• #58 Pseudogout (CPPD) – Harvard Health

  https://www.health.harvard.edu/diseases-and-conditions/pseudogout-cppd-a-to-z

  Pseudogout is a form of arthritis triggered by deposits of calcium crystals (calcium pyrophosphate dihydrate) in the joints. […] Treatment of a condition that increases the risk of pseudogout (such as hemochromatosis) may prevent development of the disease or repeated attacks. […] For people with frequent attacks, taking a nonsteroidal anti-inflammatory drug (NSAID) or colchicine daily may prevent future attacks. […] Fluid can be removed from the joint to ease the pressure. In this procedure, called joint aspiration, a needle is inserted into the joint after the area is numbed, to withdraw fluid. Treatment usually also includes NSAIDs or injections of a medication called a glucocorticoid to keep the swelling down. […] You may also need to take oral corticosteroids for a short time. Your doctor may prescribe a medicine called colchicine or an NSAID to prevent attacks.

• #59 NHS Royal Devon | Gout and pseudogout

  https://www.royaldevon.nhs.uk/services/rheumatology-musculoskeletal-system-joints/conditions-we-treat/gout-and-pseudogout/

  Some affected joints can be injected with steroid by your GP or rheumatologist. Your GP or rheumatologist can help decide which of the above medications is best suited for you. […] Secondly, medications including allopurinol and febuxostat are available. These reduce your levels of uric acid and help the crystals dissolve out of your joints. […] We aim to get the urate level well below 360μmol/L, and in fact, recent guidelines suggest we set a target of below 300μmol/L. […] Regular monthly blood tests will be needed to check your urate level and kidney function for the first 4-6 months. […] Allopurinol and febuxostat will not help during an acute attack and, in fact, during the early stages of treatment, you may experience more attacks as the crystals dissolve. […] It is important to try and adopt a ‘gout friendly’ lifestyle: maintaining a normal weight, eating a balanced diet low in fat and added sugar (in particular sugar-sweetened soft drinks), avoiding excessive intake of alcohol and high purine foods. […] We do not recommend an ‘Atkins type’ diet, which is high in purines.

• #60 Treatment and management of pseudogout: insights for the clinician

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3383522/

  The use of regular colchicine as a prophylactic agent against acute attacks of pseudogout will probably become more widespread. Similarly, drugs targeting the IL-1 pathway offer considerable potential in severe refractory disease. However, in contrast to MSU crystals in gout, there is no practical way to remove CPPD crystals from the joint. Therefore, current management strategies remain symptomatic but not disease modifying. Further research into ways of reducing the CPPD crystal burden is very necessary.

• #61 Pseudogout: Symptoms and Treatment | The Hand Society

  https://www.assh.org/handcare/condition/pseudogout

  Initial treatment includes rest and ice to the painful joint. There is no medication that can directly reduce the amount of crystals in tissue. However, there are treatment options that can improve pain and inflammation. They include: […] NSAID medications (ibuprofen or naproxen): These medications are a good option to reduce swelling and pain. However, these may have some risk in elderly patients. NSAIDs can injury the kidneys (kidney function decreases with age). NSAIDs can also decrease function of platelets, which may negatively affect patients taking blood thinners. However, NSAIDs are very commonly used, effective, and safe when prescribed and monitored by a health care provider. […] Steroids: These medications are one of the most common and effective treatments and can be given by different routes. Depending on the severity of the pseudogout, milder attacks may be treated by pills taken by mouth. More severe cases may benefit from steroids given by injection. Steroids can have some side effects. In diabetics they can increase blood sugar. Sometimes a lower dose steroid can result in fewer side effects.

• #62 Updated Treatment for Calcium Pyrophosphate Deposition Disease: An Insight

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6411330/

  Interleukin-1 receptor antagonists, namely anakinra, are recombinant genetically modified biopharmaceutical drugs that competitively bind to the interleukin-1 receptor, preventing the action of interleukin-1, a very prominent cytokine in the pathway of inflammation; thus halting the assembly of an inflammasome complex. […] Theoretically, any pharmacological or surgical approach that works to inhibit the origination of CPP crystals or promotes the dissolution of crystals can cure CPPD arthropathies; hence, more research is required in this area to explore better interventions. […] The availability of high levels of free inorganic phosphate in the extracellular matrix of chondrocytes seem to lay the foundation of calcium crystals, therefore using pharmacological agents that can lower the free phosphate levels such as probenecid, phosphocitrate (PC) and polyphosphate (polyP) can prevent CPP crystal formation. […] CPPD is an umbrella term encompassing all the various clinical subsets of CPP crystal-related arthropathies. NSAIDs, CSs and COL still remain the standard drugs to treat acute pseudo-gout; but unfortunately, they have been observed to be less successful in treating chronic cases.

• #63 Treatment strategies for calcium pyrophosphate deposition disease

  https://www.explorationpub.com/Journals/emd/Article/100756

  Although CPPD can be idiopathic, some cases of CPPD may be associated with underlying disorders such as primary and secondary hyperparathyroidism, hypomagnesemia, hypophosphatasia, hemochromatosis, Gitelman syndrome, previous joint surgery, metabolic risk factors such as obesity and hypertension, and chronic gout. […] There is a clear need for randomized controlled trials to determine the most effective therapies for CPP crystal arthritis.

• #64 How Does Physical Therapy Help Manage Pseudogout? — Best Bainbridge Island Physical Therapy Clinic For Pain Relief, Injury Prevention & Rehabilitation

  https://fiziologix.com/blog-fiziologix-physical-therapy-tips-and-self-healing/8/13/2023/how-does-physical-therapy-helps-manage-pseudogout

  Education: Physical therapists can provide education about joint protection techniques, proper body mechanics, and lifestyle modifications to minimize joint stress and prevent exacerbation of pseudogout symptoms. […] Assistive Devices: Depending on the severity of the condition, physical therapists may recommend the use of assistive devices such as braces, splints, or walking aids to provide additional support to affected joints. […] Individualized Treatment: Physical therapy plans are tailored to each individual’s specific needs, taking into consideration the location and severity of pseudogout symptoms, as well as the person’s overall health and activity level. […] It’s important to note that physical therapy is just one component of a comprehensive treatment plan for pseudogout. Medical interventions, such as medications to manage inflammation and pain, are typically prescribed by a rheumatologist or other medical professional.

• #65 CPPD Deposition Disease | UW Orthopaedic Surgery and Sports Medicine

  https://orthop.washington.edu/patient-care/articles/arthritis/cppd-deposition-disease.html

  During times when CPPD crystal deposition disease is not active, strengthening exercises can be done to ensure maximum function and stability of your joints. […] Your doctor or physical therapist can help you plan an exercise program and can explain specific kinds of exercise to do during flares and remissions of the illness. […] Some medicines are used for short term relief from pain. Others are used to keep the disease under long-term control. Nonsteroidal anti-inflammatory drugs (NSAIDs) are the medicines used most often. […] Corticosteroids are a synthetic form of a natural body hormone cortisone. […] Colchicine has been shown to be mildly effective in preventing joint pain and swelling as well as in treating sudden attacks of pain. […] In a few patients, surgery may be used to reduce pain and improve movement in a joint that is badly damaged or unstable. […] Joint aspiration is the process of removing some fluid from the sore joint(s). This not only helps your doctor determine if you have the disease, but it also removes many of the CPPD crystals that cause the pain and swelling.

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