Pseudogout can be divided by course and cause:

1. Acute pseudogout:
   • Sudden, painful joint inflammations reminiscent of an acute gout attack.
2. Chronic pseudogout:
   • Long-lasting joint inflammations with recurring episodes that can impair joint function.
3. Asymptomatic chondrocalcinosis:
   • Deposits of CPP crystals without noticeable symptoms, often discovered incidentally on X-rays.

The main cause of pseudogout is the deposition of calcium pyrophosphate crystals in the joints. These can be promoted by various factors:

- **Age:**

- The risk of crystal formation increases with age.

- **Hereditary factors:**

- A familial predisposition can promote the development of pseudogout.

- **Underlying conditions:**

- Conditions such as hyperparathyroidism, hemochromatosis, or hypomagnesemia promote crystal formation.

- **Joint damage:**

- Pre-existing osteoarthritis or previous injuries increase the risk.

The symptoms often resemble those of gout but differ in location and progression:

• Sudden joint pain:
  • Usually in a single large joint, such as the knee or wrist.
• Swelling and redness:
  • The affected joint is visibly swollen, red, and overheated.
• Movement restrictions:
  • Pain and swelling lead to limited mobility.
• Recurring episodes:
  • The condition can recur at irregular intervals.
• Chronic complaints:
  • With a prolonged course, permanent joint damage can occur.

The diagnosis is made through medical history, clinical examination, and specific tests:

- Medical history:

- Recording of joint complaints, flare-ups, and possible pre-existing conditions.

- Physical examination:

- Checking the affected joints for swelling, redness, and movement restrictions.

- Laboratory tests:

- Inflammatory markers such as CRP and ESR are often elevated.

- Analysis of joint fluid: Detection of CPP crystals under the microscope.

- Imaging techniques:

- X-ray: Detection of calcifications in the joints.

- Ultrasound: Visualization of inflammatory processes and crystal deposits.

Conservative Therapy

The treatment focuses on alleviating symptoms and preventing further flare-ups:

• Medication Therapy:
  • NSAIDs to relieve pain and inflammation.
  • Corticosteroid injections for severe discomfort.
  • Colchicine to prevent and treat acute flare-ups.
• Physiotherapy:
  • Promoting joint mobility and preventing stiffness.
• Cold Applications:
  • Cooling the affected joints for pain relief.

Surgical Therapy

Surgical interventions are rarely necessary but may be required for severe joint damage:

• Joint Lavage:
  • Removal of crystal deposits from the joint.
• Endoprosthetics:
  • Replacement of the joint in case of irreparable damage.

The following measures are helpful in preventing pseudogout:

1. Treatment of underlying conditions: Control of metabolic disorders such as hyperparathyroidism or hemochromatosis.
2. Balanced diet: Avoidance of excess calcium or other minerals.
3. Regular exercise: Promotion of joint health through joint-friendly activities such as swimming.
4. Early detection: Regular medical check-ups for at-risk patients.