Gout vs pseudogout

[Guest guest]

Hi Fliss,

Pseudogout is a condition similar to gout (crystal arthropathy)

that was initially confused with gout clinically. Even though the

scientists / doctors couldn't see crystals when first trying to

diagnose it, the symptoms were similar enough to gout that

doctors called it pseudogout to indicate an illness thought to be

gout but didn't have the crystals (kinda like sero-negative RA is

referred to now - all the signs and symptoms of RA but no RF

detected). However, a young medical doctor / researcher was

able to detect a different type of crystal in the fluid that was not

monosodium urate. When x-ray crystallography was done it was

found that this crysal is Calcium PyroPhosphate Dihydrate so

now what was called pseudogout is referred to as CPPD

disease. Unlike gout, the metabolic reason / deficiency behind

calcium crystals are not known to a sure extent. Research is

very intense to find out why some people get it and others don't -

hopefully with the idea to get new and better selected medicines

to control this disease. It seems to be linked somewhat to

hyperparathyroidism (? but don't quote me on that, it may be

thyroid problems not the parathyroid I always get those two

mixed up! and the association may not be panning out either as

research continues) Anyways, the docs always like to check your

blood levels of either the parathyroid or thyroid and then the

calcium levels too I think, but again I am fuzzy on this, way fuzzy

so much so, maybe I shouldn't even be mentioning this (am I

being ambigous enough?). But there are acceptable and well

working meds that can help people with this. Gout on the other

hand, is a well known, highly studied and pretty much all figured

out - although new meds are always welcome as well as new

ways to control flares and organ damage. As far as diagnosing

it, it all depends on the competence of the doctor and the lab -

the quality of the microscope and the experience of the person

looking at the fluid. Not all rheumatologists are crystal experts -

alot just concentrate on autoimmunity (sjogrens, lupus, etc). If

you have access to London medicine, someone I worked with is

practicing there, the last I heard. She is a crystal rheumatologist

and someone I could highly recommend (because I taught her

how to look for and identify gout and pseudogout crystals). If she

is not there, maybe you can find out where she is practicing and

if she is not too far away, may be a good fit for you. I can email

you her name if you want.

The one thing that I can say about gout is that when it flares - you

know it. People report that it is so painful that someone walking

in another room will jar the foot so bad that it is unbearable. Even

putting a low weight cotton sheet over it when sleeping is

excruciating - or traffic in the street rumbling by..... The toe will

look red, almost infected-like and will be warm, I think - but of

course you can get it in other places too besides your

toe....wrists, knees, ankles, fingers, earlobes, etc.

Anyways - again more than you probably really want to know.....

but they don't call me goutbuster for nothing! (if you see that

doctor that I am talking about and mention that name, she will

know who you are talking about!!!!)

Laurie

(I am feeling a little better pain wise - I think the trigger point

injections are doing some good but unfortunately I have to stop

them as our insurance will not cover them. The nausea though

is still a bear.)

Oh and I have to confess I think I missed your original message

about gout.........