Pseudogout

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Treatment

In most cases, pseudogout self-resolves (improves on its own) in time. The goal of treatment is to reduce pain and inflammation. Treatment often involves resting the affected joint(s) and medications. Pseudogout that develops as a result of an underlying condition (e.g., hemochromatosis, injury) may require treatment for the underlying cause.

Medications that may be used to treat pseudogout include the following:

• Nonsteroidal anti-inflammatory drugs (NSAIDs; e.g., ibuprofen [Advil®, Motrin®], naproxin [Aleve®], indomethacin [Indocin®])
• Colchicine (reduces inflammation, often used in patients with severe symptoms who cannot tolerate NSAIDs)
• Corticosteroids (e.g., prednisone; may be administered orally or injected directly into the affected joint)

Nonsteroidal anti-inflammatories and colchicine may cause side effects, including abdominal pain, diarrhea, nausea, vomiting, and bleeding in the gastrointestinal tract. NSAIDs also may cause high blood pressure and decreased kidney function, especially in older patients. Medications usually reduce symptoms in about 1 week.

When one or two joints are involved, treatment may involve removing a small amount of joint fluid and injecting a corticosteroid and an anesthetic into the joint to reduce inflammation and pain.

Severe joint damage caused by pseudogout may require joint replacement surgery.

Prevention

Small doses of colchicine may be prescribed to prevent frequent (i.e., more than once or twice per year) attacks of pseudogout. This medication may cause gastrointestinal side effects (e.g., abdominal pain, nausea) and these side effects must be considered when the drug is used long term.

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