Crystalline Arthropathies
Crystalline arthropathies are a group of disorders that involve crystal deposits in the joints and the surrounding soft tissues. The two most common forms are gout and calcium pyrophosphate deposition (CPPD), and they can cause very painful arthritis attacks.
Common Types
It’s estimated that about 4% of adults in the U.S. — 6.1 million men and 2.2 million women — suffer from gout, the most common form of crystal arthritis. )
Gout
Gout was called the disease of kings, because it was associated with rich food and drink. Indeed, a certain kind of diet is a risk factor, but anyone can get this disease. Gout is very treatable, and letting it go untreated can lead to joint damage and attacks that are more painful.
Calcium Pyrophosphate Deposition (CPPD)
CPPD is sometimes called pseudogout, because its onset resembles gout. A person’s chances of getting CPPD increase with age.
Causes & Risk Factors For Each
Though both involve crystals setting off painful inflammatory responses, gout and CPPD have varying causes and risk factors.
Gout
Gout occurs when a person has high levels of uric acid in the blood and it forms monosodium urate (MSU) crystals. This might occur because the body produces too much uric acid or doesn’t eliminate it quickly enough. These urate crystals accumulate in the joints and surrounding tissue, setting off a major inflammatory response from the immune system and severe pain.
Risk factors for gout include:
- A diet that increases uric acid levels (red meats, alcoholic beverages, shrimp, oily fish, and soft drinks)
- Weight
- Medical conditions, such as high blood pressure, diabetes, obesity, metabolic syndrome, and heart and kidney diseases.
- Certain medications, like diuretics, hypertension medicine and anti-rejection drugs for transplant patients.
- Surgery or other trauma.
- Having other family members with gout.
- Men are more likely to get gout between the ages of 30 and 50 and women are more likely to get it after menopause.
CPPD
CPPD is very similar to gout in that it involves crystals forming in the joints. However, CPPD develops from a different type of crystal: calcium pyrophosphate crystals.
Risk factors for CPPD include:
- Risk increases with age.
- Joint trauma. A serious injury or surgery.
- Family history.
- Mineral imbalances, such as hypercalcemia (too much calcium), hemochromatosis (too much iron), hypomagnesemia (lack of magnesium)
- Endocrine disorders, such as an underactive thyroid gland or an overactive parathyroid gland.
Symptoms For Each
These two share some symptoms between themselves and with other diseases, including osteoarthritis and rheumatoid arthritis.
Gout
- Rapid onset
- Inflammation and redness
- Severe joint pain, most often in a big toe
- Limited range of motion
- Continued joint tenderness, possibly for a few weeks
- Increasing frequency of attacks
CPPD
- Severe joint pain, most often in a knee
- Warmth and swelling
- Continued discomfort, possibly up to two weeks
- Joint stiffness
- Fever
Diagnosis & Treatment For Each
Scientific and medical progress allow patients with rheumatic diseases to access state-of-the-art diagnostic and therapeutic options. Doctors can help crystalline arthropathy patients return to their daily, active lifestyles.
Both gout and CPPD are diagnosable using:
- Joint fluid test
- Blood test
- Urine test
- X-rays
- Ultrasound
- Dual-energy computerized technology
Gout
Treatment methods for gout include:
- Over-the-counter and prescription forms are used to relieve joint pain.
- Prednisone and other forms may be given in pills or injected into joints to reduce inflammation and pain.
- This drug is used to prevent attacks or tamp down an attack, but it has serious side effects.
- Allopurinol and febuxostat. These drugs limit the production of uric acid.
- This drug helps the body rid itself of uric acid.
CPPD
Treatment methods for CPPD include:
- NSAIDS.
- Corticosteroids.
- Colchicine.
- Drain fluid. In severe cases, doctors will drain synovial fluid from the joint using a process called joint aspiration.
- Limited physical activity. Your doctor may recommend limiting physical activity during CPPD attacks.
- Surgery. Doctors use surgery to repair and replace joints in those who suffer extreme joint damage.
Getting Your Life Back
The pain from gout and CDDP can be debilitating. You can look for relief at our Department of Rheumatology, where specialists are dedicated to providing you with arthritis-related pain relief.
Make an appointment today with our rheumatology team by clicking here.
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