Pseudogout is an arthritic condition that causes sudden, severe episodes of joint pain, swelling, and redness, often mimicking an attack of gout. It is technically known as Calcium Pyrophosphate Deposition (CPPD) disease, characterized by the accumulation of calcium pyrophosphate crystals within the joint cartilage and surrounding tissues. While the exact cause of crystal formation remains unknown, prevention focuses on managing the underlying factors that increase risk. Proactive measures can significantly reduce the frequency and intensity of these attacks.
Identifying the Underlying Risk Factors
Advanced age is the most significant factor contributing to pseudogout, with the presence of calcium pyrophosphate crystals becoming increasingly common in individuals over 60. Approximately half of all people over 85 years old have these crystals. This age-related susceptibility is thought to be linked to changes in joint cartilage that favor crystal formation over time.
Several metabolic and endocrine disorders also increase the risk of CPPD crystal formation. Conditions such as hyperparathyroidism (high calcium levels in the blood) or hemochromatosis (excess iron stores) are strongly associated with the disease. Low levels of magnesium in the blood, known as hypomagnesemia, appear to promote crystal formation by altering the solubility of the calcium pyrophosphate.
A history of physical joint damage acts as a trigger for the disease. Previous joint trauma, such as a sports injury or surgery, can create an environment conducive to crystal deposition. CPPD disease can also run in families, suggesting inherited factors influence an individual’s susceptibility to crystal formation.
Medical Strategies for Long-Term Prevention
Preventing recurrent pseudogout attacks requires a physician-directed approach focused on prophylactic treatment and managing underlying systemic conditions. For patients who experience frequent episodes, a doctor may recommend low-dose colchicine, which can be taken daily as a preventive measure. The drug works by reducing the inflammatory response triggered by the calcium pyrophosphate crystals.
Another medical strategy involves the prophylactic use of nonsteroidal anti-inflammatory drugs (NSAIDs) at a reduced dose to minimize inflammation and the severity of future flares. However, due to the increased risk of gastrointestinal or kidney issues, particularly in older adults, this long-term use must be closely monitored by a healthcare provider.
Addressing the underlying metabolic disorders is a critical component of long-term prevention. If tests reveal an overactive parathyroid gland or abnormal iron levels, treating these specific conditions is important, as they contribute to the environment that allows CPPD crystals to form. Regular monitoring of joint health through imaging and blood tests for mineral imbalances is necessary to track progression and adjust treatment plans.
Daily Lifestyle and Dietary Adjustments
Daily habits and lifestyle modifications play a supportive role in reducing the risk of pseudogout flares and improving overall joint health. Maintaining a healthy body weight is important, as excess weight places greater stress on large, weight-bearing joints like the knees. Reducing this strain helps protect the joints from the micro-trauma that can potentially trigger crystal deposition.
Protecting joints from physical injury is a significant non-pharmaceutical step, as joint trauma is a known trigger for acute attacks. This involves being mindful of high-impact activities and using appropriate joint support, especially during exercise. Focusing on anti-inflammatory foods can help manage the body’s general inflammatory state.
Ensuring adequate hydration is important, as sufficient water intake supports joint lubrication and the body’s natural processes. For individuals with diagnosed hypomagnesemia, dietary changes to include magnesium-rich foods like almonds, spinach, and whole grains may be beneficial. Magnesium supplementation may also be recommended, as magnesium is known to increase the solubility of the calcium pyrophosphate crystals.