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Tuesday, March 11, 2014
Arthritis and Rheumatism
Can "Laser" Arthroscopy Treat Pseudogout?
Doctor tells me I have Pseudogout. He drained my knee & injected Cortisone in the same drain hole. One week later pain was still there. X-rays showed crystal build up. Can the crystals be lasered from my knee through arthroscopy? How can I prevent this from recurring? Thank you.
Pseudogout is the acute inflammation of a joint that occurs as a reaction to a calcium pyrophosphate dehydrate (CPPD) crystal in the joint. The symptoms of a pseudogout attack can be quite similar to an acute episode of gout from a monosodium urate crystal, thus, the name pseudogout.
"Laser" is via arthroscopy and is not a treatment for pseudogout. Acute attacks are often treated via intra-articular corticosteroid injection. Alternatively, acute attacks may be treated with colchicine or non-steroidal anti-inflammatory medicines (NSAID's). Prevention of acute attacks may be possible by taking daily, prophylactic colchicine or NSAID's as long as you do not have a contraindication to chronic use of these medicines.
It is worthwhile to be screened for an underlying metabolic imbalance or disorder as the cause of CPPD crystal deposition in the joints. For example, CPPD deposition may be associated with elevated parathyroid hormone, low magnesium, or a hemachomatosis (a disease with excessive iron deposition).
Raymond Hong, MD, MBA, FACR
Formerly, Assistant Professor of Medicine
School of Medicine
Case Western Reserve University