抄録
Objective: To clarify the clinical features of pseudogout (also called calcium pyrophosphate dehydrate (CPPD) crystal deposition disease) showing a variety of symptoms.
Methods: The clinical features of 73 patients with pseudogout were surveyed. Of those, 23 were male and 50 were female. The average age was 82.8. We surveyed (1) age, (2) the number of punctured joints, (3) The appearance rate of postoperative or posttraumatic pseudogout, (4) the number of recurrent cases, (5) X-ray findings on the affected joints, and (6) complications and family history.
Results: By age, patients in their eighties came on top of the list at 56.2%, followed by those in their seventies at 23.3% and those in their nineties at 16.4%. By joint, the knee joint accounted for 83.6%, the ankle joint 6.8% and the elbow joint 5.5%. Of the surveyed patients, 20.5% of the patients had pseudogout attacks postoperatively or following other medical trauma. The attacks began on postoperative day 4.1 on the average. A recurrence of attacks was noted in 37.0%, and 11.0% of the patients had attacks in multiple joints. X-ray findings revealed characteristic calcifications in 83.0% of the cases and arthritic changes in 77.4%.
Conclusions: Our present study seems to indicate that (1) pseudogout should be suspected when we examine elderly patients with acute arthritic symptoms, especially when they have a history of similar arthritic episodes. However, suppurative arthritis seems to be the most important disease in differential diagnosis. (2) We should note that pseudogout attacks occur also in joints with no radiological evidence. (3) There seems to be a close relationship between the CPPD crystal deposition disease and osteoarthrotic changes and joint destruction. Therefore, we should carefully follow up patients with pseudogout to minimize progression of their joint damage.
