Medical Q&As

Pseudogout - related to gout?

In Feb 2001, my big toe became very swollen. My doctor suggested it might be gout and ordered a blood test that proved to be normal. Two months later it cleared. Now, April 2002 and my big toe has swelled again. For two days I have rested and the pain has eased. What could be wrong?

I assume that the blood test that your GP performed was for the purpose of measuring uric acid in your blood. If excessive levels of uric acid are circulating in the blood some of that material crystallises in the joints and triggers an acute inflammatory reaction, which we recognise as gout. You say that your blood test was normal, which leads me to suspect that you have a gout-related condition known as pseudogout. Gout and pseudogout produce identical symptoms. In the case of pseudogout the acute inflammation in the joint is due to calcium crystals and not uric acid crystals. Treatment of the acute phase of pseudogout is identical to that of gout and involves the use of anti-inflammatory medication. However, unlike gout there is no specific preventive treatment available to prevent an attack of pseudogout. It might be worthwhile discussing with your doctor the possibility of measuring the levels of calcium in your blood. Elevated calcium levels can in some cases give rise to attacks of pseudogout.