What is acute CPP crystal arthritis (pseudogout)? How does it present?
Acute CPP crystal arthritis (pseudogout) is an acute arthritis with rapid onset of pain and swelling. Physical exam reveals warmth, swelling with effusion, tenderness, and limited range of motion of the involved joint(s). Overlying erythema may simulate cellulitis. Occasionally systemic symptoms such as malaise and fever will also raise suspicion of infection ( pseudoseptic arthritis ). Attacks of pseudogout tend to be less painful and take longer to reach peak intensity than attacks of gout. Usually, only a single joint is affected, although oligo- and polyarticular pseudogout have been described. Large joints are affected more commonly than small joints, with the knee and wrist most frequently involved. Notably, the first metatarsophalangeal joint is rarely involved. Untreated pseudogout is self-limited, resolving within ≥7 to 10 days. Patients are typically asymptomatic between attacks.
