Is pseudogout the same as gout?

No. Both are crystal arthritis and an attack can look identical, but they’re caused by different crystals (calcium pyrophosphate vs uric acid), tend to affect different joints (knee/wrist vs big toe), and are managed differently long-term. Gout can be treated with medicines that dissolve the crystals; pseudogout has no such equivalent.

Can pseudogout be cured?

There is no way to remove the crystals, so it can’t be “cured” in that sense. However, attacks can be effectively treated and, where they’re frequent, reduced with preventive medication, and any underlying condition can be addressed.

When should I go to hospital?

Seek urgent assessment for a first attack, a severe attack, or any hot, swollen, very painful joint – especially with fever or feeling unwell – because a joint infection (septic arthritis) is a possibility that needs to be excluded quickly.

Does what I eat cause pseudogout?

Unlike gout, pseudogout is not linked to diet or uric acid, so dietary changes are not a treatment. It is driven mainly by age and, in some people, underlying metabolic conditions.

I was told I have “chondrocalcinosis” on an X-ray but have no pain – do I need treatment?

Calcium in the cartilage seen on X-ray is common with age and often causes no symptoms. If you have no pain or attacks, it usually needs no treatment – only monitoring, and treatment if attacks develop.

Pseudogout (CPPD) Singapore | Symptoms, Gout Difference & Care

Written & reviewed by the BestDoctors.sg editorial team · Last updated 24 Aug 2026 · General information, not medical advice

Quick answer. Pseudogout is a form of crystal arthritis in which calcium pyrophosphate crystals – not the uric acid crystals of gout – build up in and around joints and can suddenly trigger a hot, swollen, very painful joint. It most often strikes the knee, wrist or shoulder in older adults, and because an acute attack can look identical to gout or a joint infection, a first or severe episode (especially with fever) needs urgent medical assessment.

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In a medical emergency, or for severe or sudden symptoms such as breathing difficulty, chest pain, fainting or stroke signs, call 995 immediately.

The safety point that matters most: a sudden hot, swollen joint can be pseudogout, gout or a joint infection (septic arthritis) – a medical emergency. A first or severe attack, especially with fever, should be assessed urgently to exclude infection.

What pseudogout (CPPD) is

Pseudogout is one of the “crystal arthritis” conditions, in which microscopic crystals form inside a joint and provoke intense inflammation. Here the culprit is calcium pyrophosphate. These crystals deposit within joint cartilage – a process called chondrocalcinosis when seen on imaging – and can shed into the joint space, where the immune system reacts to them, releasing the pain, heat, redness and swelling of an attack. The umbrella term is calcium pyrophosphate deposition (CPPD): it can be silent (crystal deposits with no symptoms), cause sudden acute attacks (“pseudogout”), or produce a longer-standing chronic arthritis.

How pseudogout differs from gout

Although both are crystal arthritis and an attack of either can look the same, they are distinct:

The crystal differs – gout is uric acid (urate) crystals; pseudogout is calcium pyrophosphate;
The joints differ – gout classically begins in the big toe; pseudogout more often affects larger joints – knee, wrist, shoulder;
The age differs – pseudogout is a condition of older adults, with risk climbing with age;
The blood link differs – gout is linked to raised uric acid and diet; pseudogout is not driven by diet and has no urate connection;
Long-term treatment differs – in gout, urate-lowering medicine can dissolve crystals and prevent attacks. In pseudogout there is no equivalent – the crystals can’t be dissolved.

Symptoms and how attacks behave

A classic acute attack is a joint that becomes suddenly hot, red, swollen and very painful, often over hours, and too tender to move or bear weight on. The knee is the most common site. Some people feel generally unwell or feverish. Attacks usually settle over several days to a couple of weeks, sometimes longer. Beyond acute attacks, some people have chondrocalcinosis found by chance on an X-ray with no symptoms, and others develop a slower, chronic arthritis that can mimic osteoarthritis or rheumatoid arthritis.

Who is at risk

Older age is the single biggest factor. Others include previous joint injury or surgery, overactive parathyroid glands (hyperparathyroidism), haemochromatosis (iron overload), low magnesium, and coexisting osteoarthritis. When pseudogout appears in someone younger than expected or affects several joints, doctors look harder for an underlying metabolic cause.

The septic-arthritis warning

This is the most important safety point. A single hot, swollen, painful joint can be caused by pseudogout, gout or a joint infection (septic arthritis) – and these cannot be reliably told apart just by looking. Septic arthritis is a medical emergency: an untreated infected joint can be permanently damaged within days and the infection can spread. So a first attack, a severe attack, or any hot swollen joint with fever should be assessed urgently, usually in a hospital setting. The definitive way to distinguish the causes is to sample the joint fluid and examine it for crystals and infection.

Chronic CPPD and living with it

As well as sudden attacks, some older adults have a longer-standing form of CPPD that causes ongoing joint pain and stiffness, often in the knees, wrists or hands, and it can coexist with osteoarthritis. This chronic form is managed much like osteoarthritis – pain relief, staying active within comfort, physiotherapy and joint protection – alongside treating flares as they arise. Correcting a treatable underlying cause, such as low magnesium or an overactive parathyroid gland, can reduce attacks in some people, which is one reason blood tests to look for these conditions are worthwhile.

Diagnosis and treatment

Joint fluid aspiration is the definitive test – a needle draws fluid, examined under a polarising microscope, where calcium pyrophosphate crystals have a characteristic appearance that separates them from gout’s needle-shaped urate crystals; the same fluid is checked for infection. X-rays may show chondrocalcinosis, and blood tests look for treatable underlying conditions. Because the crystals can’t be dissolved, treatment calms inflammation and relieves pain during attacks: rest, ice and protecting the joint; NSAIDs where suitable; colchicine; corticosteroids (tablets or injected into the joint); and joint aspiration, which often relieves pressure and pain. For frequent attacks, preventive options (such as low-dose colchicine) may be considered, and any underlying metabolic condition is treated. Unlike gout, there is no urate-lowering equivalent. Medication choice depends on age, kidney function and other conditions – important in the older adults most affected – so it should be guided by a doctor. Seek urgent care for a hot swollen joint with fever; a rheumatologist manages recurrent CPPD.

Related autoimmune & rheumatology topics

Sources

MSD Manual — calcium pyrophosphate deposition disease: affected joints, risk factors, diagnosis and treatment; no therapy removes crystals.
Versus Arthritis — calcium crystal diseases (CPPD): acute pseudogout, chronic CPPD, chondrocalcinosis.
Arthritis Foundation — symptoms, older-age risk, inflammation-focused treatment.
Mayo Clinic / Patient.info — joint aspiration diagnosis, crystal appearance, associated metabolic conditions, septic-arthritis caution.

General information only. This guide is general information about an autoimmune or rheumatological condition and is not a diagnosis or personalised medical advice. See a doctor — a GP or a rheumatologist — for assessment and treatment; blood-test results (including autoantibodies) must be interpreted by a doctor in context. Seek urgent care for a hot, swollen, painful joint with fever (to exclude joint infection), for sudden eye redness, pain or vision changes, and call 995 for signs of a clot or stroke (sudden breathlessness or chest pain, or face drooping, arm weakness or speech difficulty — act F.A.S.T.).

Pseudogout (CPPD) in Singapore: The “Other” Crystal Arthritis