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Pseudogout?

11K views 42 replies 18 participants last post by  127.0.0.1 
#1 ·
Yeah, I never heard of it either before my knee became the size of a grapefruit.
Got a cortisone shot which cleared it up in 48 hrs but after 5 weeks symptoms have returned.
I was hoping someone here has experience and could tell me what works to treat a flare-up and anything to help prevent another one?
My big $ Ortho has been less than helpful.
Thanks!
 
#2 ·
What differentiates pseudo from the real thing? I had what appeared to be gout in my big toe a few years ago. I don't drink, but had OD'd on beef & pork for several days. Then got dehydrated on a ride.

Prescription anti-inflammatory & changed diet took care of it. I'm completely off red meat. Tart cherries (or juice) are supposed to help.
 
#6 ·
What differentiates pseudo from the real thing?
The difference is the type of crystals in the joint that cause the inflammation.
The medical term for pseudogout is calcium pyrophosphate deposition disease or CPPD.

"regular" gout is caused by deposits of monosodium urate monohydrate crystals.

My docs told me not much is known about CPPD as far as what causes it or how to prevent it. Mine doesn't seem to respond well to the NSAIDs. I did find an epsom salt soak helped get the swelling down.
 
#3 ·
never heard of pseudogout.

regular gout, i am familiar intimately with.

i gave up on my doc and had her refer me to a rheumatologist. it was game on..he explained it to me. i am now on meds and have been gout free for about 6 years. i had it on my right toe and left knee at the same time when i cried "uncle".

i got off of the meat heavy diet as well.
 
#9 ·
Unless you've had a needle in your inflamed body part and the fluid examined under a microscope you really don't know if you have gout or one of the other acute arthritis conditions with similar symptoms. A blood test for elevated uric acid levels is not the smoking gun or a definitive diagnosis.

I've had numerous gout [or psuedo gout] attacks over the years. They suck. A lot. The frequency is not enough to pursue any drastic treatments..at least not yet. I assume it will get worse.

I have not noticed any correlation with eating red meat or alcohol. Ice, rest and high strength NSAIDs do it for me. The folks I work for let me ride my MTB at work when I have an attack as we have 3 different shops I have to move between in a large area. I can pedal without pain when I can barely walk 20'.
 
#10 ·
just so you know, i was told by my doc that the flare up that causes all that pain is just a symptom of gout. you have gout even without the flareup. damage to your joints can be happening silent and painfree.

i'm on Allupurinol now. i dont think i have had an attack for 5 years. we played with the dosage just to get my uric levels below 5. strategy is to hover it there and i should be pain free. a gout sufferer gets flare up usually in the 6 range. non gout sufferer can have uric levels way higher than that and never have a flare up or joint damage.
 
#15 ·
just what my doc said. my rheumatologist. he said we have gout way before our first attack..i think he said 10 years.

i asked a lot of questions. Dr J retired or i would email him.
I can't find a single reference to this ^^^ in any medical literature. So I am skeptical. But I definitely agree each gout attack causes damage so if you have them frequently doing something about them is smart not just for the short term pain relief, but also for the long term situation.
 
#20 ·
OK, 19 posts in, and we've got 17 posts about "regular" gout and none (other than the OP's original question and explanation) about pseudogout. I was recently diagnosed with pseudogout, so would be interested to hear from others that are managing w/ pseudogout.

Despite the helpful intent, comments about normal gout aren't really relevant to the thread topic. As the OP tried to explain, although the symptoms can be similar and they both involve crystal formation, the origins of the two are totally different. Urea is a direct causal factor in normal gout, and there are a variety of diet and medication treatments that can reduce urea to treat the problem. In contrast, pseudogout, or CPDD, generally has no diet or medication treatment (other than symptomatic relief via NSAIDS or corticosteroids).

One of my frustrations, other than the knee pain, is that I can't seem to identify any consistent context for "flare-ups." I rode 35 days on the Baja Divide and the symptoms were manageable. Then I'll go do a 90 minute local ride, and for some reason my knee will ache for two days. So I get apprehensive if I'm considering a big commitment like the AZT750.

Seems like problems just keep accumulating since passing 50. I'm a bit afraid that this may be the proverbial "beginning of the end" of my cycling days, but I'm hoping it eases off, or at least doesn't worsen. My doc says that there is no statistical pattern of increasing crystal deposits / symptoms; some folks get better, some stay the same, some get worse and they don't know why. Hopefully I'll find myself among the former.
 
#21 ·
normal gout aren't really relevant to the thread topic. As the OP tried to explain, although the symptoms can be similar and they both involve crystal formation

One of my frustrations, other than the knee pain, is that I can't seem to identify any consistent context for "flare-ups." I rode 35 days on the Baja Divide and the symptoms were manageable. Then I'll go do a 90 minute local ride, and for some reason my knee will ache for two days. So I get apprehensive if I'm considering a big commitment like the AZT750.
dehydration is very bad for crystal build-up

Mineral imbalances. The risk of pseudogout is higher for people who have excessive calcium or iron in their blood or too little magnesium. (Mayo Clinic)

Colchicine (Colcrys). Low-dose pills of this gout drug are also effective for pseudogout. If you have frequent episodes of pseudogout, your doctor may recommend that you take colchicine daily as a preventive measure. (Mayo Clinic)

Seems there are some similarities

Apply all the gout fixes....doesn't hurt

drink lots of water
 
#25 ·
I'm 55 and was diagnosed by a GP as having Gout but my wife, a pharmacy tech, said my diet and lifestyle didn't fit that diagnosis. So I went to a Podiatrist and the x-rays proved that I didn't have Gout, but rather arthritis in the big toe joint due to a long toe. Over the years I've had "Gout like" flare-ups and even a swollen knee (from overly tight hamstrings causing the patella to be pulled out of alignment) and I'm forced to get a steroid to ease the swelling and pain. For the last few years I would feel my feet ache after a ride and I would worry about a flare-up, but the flare-ups occur randomly. This past winter I tried flat pedals due to freezing conditions, and noticed less pain. After some research and advice from a friend I tried flats from http://pedalinginnovations.com/ and after 2 months I can feel the difference. These pedals re-position your feet so there is less pressure on the toes and ankles and spreads the "load" to the entire foot. Perhaps you are experiencing similar flare-ups....hope this helps.
 
#26 ·
After some research and advice from a friend I tried flats from http://pedalinginnovations.com/ and after 2 months I can feel the difference.
Hah! Coincidentally I just did my first ride in 15 years on flats last night, so very timely comments. Those long pedals from Pedaling Innovations look interesting, thanks for pointing them out. I'm surprised they didn't mention Joe Friel and Steve Hogg, two widely known cycling coaches who have been advocating mid-arch cleat positions in road biking for years.
I have a chronic but moderate pain under the ball of my left foot, unrelated to the pseudogout as far as I know, which I'm hoping will diminish w/ use of flats. But my initial motivation was to learn better riding technique and to get my body accustomed to flats so that I can use them on long bikepacking trips. Maybe I'll check out the PI pedals.
 
#27 ·
The pain in the ball of your foot sounds familiar. Have you had a podiatrist x-ray it? The arthritis in my feet (yeah, I'm lucky enough to have it in both) coupled with my flat foot and plantar fasciitis makes it a real problem to keep up with. New foot position has been remarkable, as well as the epsom salt soaks.....good luck
 
#29 ·
OP here - here's what I've learned /observed since my post in Nov.
Since I wasn't responding to the NSAIDS, my Dr gave me an Rx for low dose steroids. If I feel symptoms coming on (usually starts as stiffness in my ankle/knee) I take a couple of them and it knocks it right out before it becomes a full-blown outbreak. I've done this 2 or 3 times since Nov.

I do think that hydration plays a part. I've starting keeping a bottle of water on my desk at work. I also think alcohol plays a part in bringing it on, as does stress.
I've also started taking Turmeric supplements. Not sure if it really helps but right after I ran out, I felt the symptoms coming on so I started taking it again.

Since I now have a way to treat an outbreak before it gets started I think it's certainly manageable. If I start having to take the Rx every week, that would be cause for concern.
 
#30 ·
I can attest to stress being a factor, I'm in denial about alcohol though. You may want to add Alfalfa to your supplement regimen....

Alfalfa aids in pain and stiff joints from swollen knees and swelling of ankles and feet. Alfalfa is a natural diuretic and helps regulate the body's acid/alkaline balance. Recognized for centuries for its healing properties, alfalfa contains eight digestive enzymes, calcium, phosphorus, iron, magnesium, chlorophyll, bioflavonoids, trace minerals and vitamins.

The alfalfa plant is also popularly used as an alternative natural source in homeopathic medicines worldwide. Today, alfalfa is suggested for treating gout and gouty arthritis, most other arthritis types, kidney and bladder problems, colon problems, anemia, asthma, diabetes, ulcers, stomach ailments, prostate conditions, gas pains, hiatal hernia and water retention. Alfalfa Supplements â€" An Arthritis Remedy without Drug Side Effects

You may have better luck with Circumin if n-saids were no help, but you are already taking Turmeric so you should be careful there.
 
#31 ·
I was hoping someone here has experience and could tell me what works to treat a flare-up and anything to help prevent another one?
My big $ Ortho has been less than helpful.
Thanks!
I was diagnosed a few years ago, with Pseudogout in both knees, confirmed by X-rays. The doctor showed me the crystalline deposits. As "luck" would have it, I had also broken 2 ribs during a fall around that time. Researching what to do for broken ribs, led me to what I am convinced may be a cure for Pseudogout. I ordered some Cissus Quadrangularis from Amazon, which is supposed to help fractured bones heal faster. A few days after taking only half the recommended dosage, my knees quit bothering me. I took the CQ for about 2 years, then began slacking off to see if my knee problem would return. It hasn't, so far. I don't even take the CQ any more, it's probably been about a year now since I quit taking it.
I'm hoping that someone else will try this and let us all know if it helps for their Pseudogout. You can buy it from Amazon. It's a natural product made from a grape vine. It's also very cheap. The brand name that I have used is Absonutrix but there are many others. Read the reviews, do some research, and give it a try if you are still looking for a possible (and natural) solution.
I hope it helps someone else like it has helped me.
 
#34 ·
Taking tumeric (curcumin) for my arthritic knuckles... the water on my knee has cleared up. I can now kneel without discomfort, had not been able to do that for several years. No allergy symptoms for two years now either, nice perk.
 
#39 ·




I am 70 years old. RA hit me at 50. The pain was constant. My legs, feet, ankles, knees, hands, wrists all in pain. Because of the pain, I sat on my butt for 17 years, until retired, so my leg muscles did not support me very well. I had developed severe knots of pain in my left leg. I got Mad at the pain, pressed hard against the knot until it finally relented. Then I discovered the bubbles in my left leg. But my right leg did not display the same way. So reasoned that the bubbles should not be in my left leg and I started to crush them. I went to bed that night and for the first time in 17 years, my left leg laid in bed, CALM, no pain. Amazing. The bubbles and crystals attach to the tendons for their energy(parasite?). Scrape them off of the tendons. The bubbles and crystals are more interested in the tendons, than the bone.
To crush the bubbles and crystals, I use the top of my fingernail to push down and away on the crepitus and pop the bubbles. try not to dig in with end of the finger. The skin will suffer, work on another areas until it heals. You might use a spoon. The bubbles are arthritis. I think the bubbles are parasites, because, when you pop the bubbles more push in behind it, to replace the bubbles, I just popped. I call my work with my fingers 'scrapping'. I can scrape in one same area for a full minute before I pop all of the bubbles in that vicinity.
The crystals are just the excrement of the bubbles. If you crush the crystals, they will be absorbed by your body and flushed out through the poop shoot. AND THE PAIN GOES AWAY!
I first starting scrapping about three years ago, it has been a continual process. The muscle redevelopment takes a long time. I can walk again and am riding a bike 8 miles a day.
My rheumatologist does not understand what I am doing, but I can walk again, so it is a good thing.
 
#42 ·
Did you give it a try? If so, how did it work?

Any additional information to report since your last post on pseudogout treatments?
I didn't. I had to look at the date on these posts and see they are from 2019.
Happy to say I can't remember the last time I had a flare up, but it has to be at least pre-covid days. No idea why but knocking on wood just the same.
 
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