Acute pseudogout treatment: what to expect

A clinician may use an anti-inflammatory medicine, remove fluid from the affected joint, or inject a corticosteroid after assessing whether infection is a concern. Resting the joint briefly and using a wrapped cold pack can also reduce discomfort.

Pseudogout, also called calcium pyrophosphate deposition disease or CPPD, occurs when crystals trigger inflammation inside a joint. A flare may bring sudden pain, warmth, stiffness, tenderness and swelling, often affecting one joint at a time.

These features can resemble gout or a joint infection. Joint fluid may therefore be removed and examined for crystals and signs of infection, especially when the diagnosis is uncertain or the joint is markedly hot and swollen.

Arrange a medical assessment, particularly for a first episode. Until reviewed, reduce load on the painful joint, support it in a comfortable position and apply a cold pack through cloth for short intervals. Avoid strenuous exercise and do not massage a severely inflamed joint.

Medication choice depends on kidney function, stomach or bleeding problems, other medicines and the number of joints involved. Do not start or combine anti-inflammatory medicines without checking that they are suitable for you. If joint fluid is removed, follow the clinician's advice for keeping the puncture site clean.

Seek urgent medical assessment for a suddenly hot, red and swollen joint with fever, chills, feeling very unwell, a recent wound or procedure near the joint, or an inability to bear weight. A joint infection can look similar to pseudogout and needs prompt treatment.

Get further advice if pain or swelling worsens despite treatment, if medicine causes breathing difficulty, facial swelling, black stools or vomiting blood, or if the flare prevents drinking, walking or managing essential daily activities.

Ask whether joint aspiration is needed to distinguish crystals from infection, which medicine fits your health history, and what to do if another flare starts. You can also discuss whether an underlying trigger or joint condition needs assessment after the acute inflammation settles.