Whitesburg KY
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Gout vs. pseudogout: What’s the difference?



DEAR DR. DONOHUE: I have faux gout. At least that’s what I’ve been told I have. It’s in my left foot. I understand it’s not caused by uric acid but by calcium. Can you tell me more about it and what can be done for it? — C.B.

ANSWER: Faux (French for “false”) gout — or pseudogout, as it is more commonly called — is like gout in many respects, but the differences between the two are significant.

In gout, uric acid crystals infiltrate joints and inflame them. In pseudogout, the crystals making their way into and around joints are calcium pyrophosphate dehydrate, CPPD. Just as uric acid crystals do, CPPD crystals inflame the joint and cause great pain. That’s not true of everyone who has these crystals. Some never experience a minute of pain.

The joints most affected in pseudogout are the knees and the wrists. Shoulders, ankles, elbows and hands also might be targets.

Who told you that you have this condition? A doctor requires X-ray examination of the affected joint before declaring that a person has pseudogout. Stronger evidence of the diagnosis is obtained by drawing fluid from the joint and examining it microscopically. The distinctive crystals of CPPD can be seen — proof positive.

Nonsteroidal ant i – inflammatory drugs — Aleve, Motrin, Advil and many others — usually can control this illness and the pain it causes. If they don’t, an injection of cortisone into the joint will. For recurrent attacks, colchicine — the same drug used for gout — works for pseudogout, too.

The pamphlet on gout and pseudogout explains both illnesses and their treatments. To obtain a copy, write: Dr. Donohue — No. 302W, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 with the recipient’s printed name and address.


DEAR DR. DONOHUE: My wife of 41 years has tremors. She is 62. The tremors started in her mid-50s. Her mother is 85 and shakes so bad she can’t write or hardly help herself. They told her it is hereditary. Is there any medication or treatment available? My wife is getting very frustrated. She’s not able to carry out simple tasks. — P.E.

ANSWER: Your wife and mother-in-law most likely have familial tremor, also called essential tremor. It does run in families. There is treatment. Propranolol (Inderal) and primidone (Mysoline) work very well for most. Both your wife and her mother should be getting treatment. A neurologist is the doctor who specializes in tremors and their treatment.


DEAR DR. DONOHUE: My husband and I wish to leave our bodies to science but do not know whom to contact. How do we go about this? — E. and C.D.

ANSWER: You and your husband deserve a round of applause. Most medical schools have a body-donation program. Contact the medical school nearest you and ask for the anatomical donation committee or the anatomy department.

If you can’t make contact with a medical school, three organizations can assist you in donating your bodies: MedCure (866-560-2525), BioGift (866-670-1799) and Science Care ( 800- 417- 3747). ©2011 North America Synd.

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