The Difference Between Gout and Pseudogout

Gout and pseudogout have similar characteristic but there are also important differences between gout and pseudogout.

This list of similarities and differences—broken down by symptoms, causes, risk factors, and treatment and prevention—can help you understand and compare the disorders.

  1. Symptoms

The difference between gout and pseudogout when comparing symptons isn’t great. In both cases there is likely to be an unexpected and sudden, sharp pain, usually in one joint.

The location of the pain is the main symptomatic difference between gout and pseudogout.

Over 50% of gout attacks are in the big toe, which is the stereotypical image that historically comes up when gout is mentioned. Other locations commonly affected by gout are the wrist, fingertips and the heel.

Pseudogout tends to occur most frequently in the knee but can also affect the wrist, hip ankle or shoulder.

  1. Causes

Both gout and pseudogout are caused by too much of a certain substance in the body, which then crystallizes in a joint and causes pain.

The difference between gout and pseudogout in causality is that gout is caused by a rise in the concentration of uric acid in the joint.

Pseudogout is caused by excessive calcium pyrophosphate, and is sometimes referred to as CPPD – calcium pyrophosphate deposition.

  1. Risk factors

Risk factors are largely the same for both gout and pseudogout.

One significant difference between gout and pseudogout is that gender and ethnicity are risk factors for gout but not for pseudgout. Gout is more prevalent in males than females, while males of African ancestry are more likely to experience gout than Caucasian males.

The other risks factor are pretty much the same for both conditions – age*, family history and old injuries in the relevant joint.

* Gout usually appears between 30 and 50 years of age and the incidence increases with age.

 

  1. Treatment and prevention

In general, treatments don’t present much of a difference between gout and psuedogout. Pain relief from gout attacks may be gained from medications, rest and, in some cases, ice to relieve the inflammation. For chronic, long term conditions cortisone injections can provide relief and, less frequently these days, surgery.

Lifestyle changes are becoming an increasingly popular avenue to treat gout. This is where evidence and hearsay sometimes clash. There certainly is scientific evidence to suggest that lifestyle changes does alleviate gout pain and lessen gout attacks. However, some of the claims for particular lifestyle changes are extreme or the beneficial effects may only be experienced by certain individuals.

The most effective lifestyle change to prevent gout attacks is to avoid purines.  However, be aware that there are different types of purines (see good purines and bad purines).  Purines, in order of concentration, come in alcohol, red meats, fish, most beans, and a few vegetables including spinach and asparagus. Weight loss, exercise and increasing levels of physical fitness may help prevent gout attacks in some individuals.

However, when the effects of lifestyle changes have been studied a major difference between gout and pseudo gout becomes apparent.

It is clear now that lifestyle changes may prevent gout attacks but, in most studies, lifestyle changes don’t appear to affect the incidence of pseudogout attacks.  This a major difference between gout and pseudogout.

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