Specialties
    Executive Health Assessment
    Our doctors
    Referrer services
    Contact us
    Request appointment
    Home
    1. Home
    2. Specialties
    3. Rheumatology
    4. Gout and Pseudogout

    Gout and Pseudogout

    At Mayo Clinic Healthcare in London, our rheumatology specialists assess, diagnose and treat gout and pseudogout. If you are looking for gout specialists in London, our consultant-led team can help identify the cause of your joint pain and recommend a treatment plan based on your needs.

    Gout and pseudogout are types of arthritis caused by tiny crystals that build up in or around a joint. These crystals can trigger sudden pain, swelling, warmth and stiffness.

    The symptoms can look similar, but gout and pseudogout have different causes. Gout is caused by uric acid crystals, also called urate crystals. Pseudogout is caused by calcium pyrophosphate crystals. Early and accurate diagnosis can help guide the right treatment and reduce the risk of future flare-ups.

    • Gout and pseudogout both happen when crystals collect in a joint. The difference is the type of crystal.

      • Gout is caused by uric acid crystals, also called urate crystals.
      • Pseudogout is caused by calcium pyrophosphate crystals, a different type of crystal that can collect in joint cartilage.

      Both conditions can cause acute inflammatory flares, often with similar symptoms such as pain, swelling, and reduced joint mobility. Because the symptoms can overlap, your specialist may recommend a physical exam, imaging tests or joint fluid analysis to confirm the diagnosis.

    • Crystal arthritis can develop when tiny crystals collect in or around a joint and trigger inflammation.

      Common mechanisms include: 

      • Metabolic imbalance leading to crystal formation 
      • Age-related changes in joint cartilage 
      • Underlying medical conditions affecting mineral or uric acid metabolism 
      • Previous joint damage or osteoarthritis 

      Gout-specific causes

      Gout can develop when uric acid builds up in the blood. Uric acid is a waste product that usually leaves the body in urine. If levels become too high, uric acid crystals can form in the joints.

      Key risk factors include: 

      • Reduced kidney function
      • Eating foods and drinks that can raise uric acid levels
      • Alcohol consumption 
      • Obesity 
      • Certain medications (e.g. diuretics) 

      Pseudogout-specific causes 

      Pseudogout happens when calcium pyrophosphate crystals collect in cartilage, the smooth tissue that cushions joints.

      Key risk factors include: 

      • Increasing age 
      • Osteoarthritis 
      • Genetic predisposition
      • Metabolic conditions (e.g. hyperparathyroidism, haemochromatosis) 

    • Both gout and pseudogout can present with sudden joint inflammation. 

      You may experience: 

      • Sudden joint pain
      • Swelling or stiffness
      • Warmth or tenderness around the joint
      • Reduced movement in the affected joint

      Symptoms may occur in flare-ups or persist for several days depending on the severity of inflammation. 

      Gout 

      Gout often affects the big toe. It also can affect the ankles, knees and other joints. Attacks often develop rapidly and may be triggered during the night. 

      Pseudogout 

      Pseudogout most commonly affects the knees, although wrists, shoulders, and ankles may also be involved. Symptoms may develop more gradually and can resemble osteoarthritis in some cases. 

    • Seek specialist assessment if you have:

      • Sudden or severe joint pain
      • Joint swelling, warmth or redness
      • Repeated flare-ups
      • Trouble walking or using the affected joint
      • Symptoms that do not improve with usual pain relief
      • Joint swelling without a clear injury

      Gout often affects the big toe or ankle. Pseudogout often affects the knee. A specialist assessment can help confirm the cause and guide treatment.

    • At Mayo Clinic Healthcare, diagnosis begins with a comprehensive consultation with a specialist rheumatology consultant. 

      Our team takes the time to understand your symptoms, medical history, and overall health before recommending targeted investigations. 

      Diagnostic tests may include: 

      Joint aspiration, a procedure that removes a small amount of fluid from the joint so it can be checked for crystals

      Joint fluid analysis is the most definitive method for distinguishing between gout and pseudogout, helping to guide appropriate treatment. 

      Different patients require different investigations, and your diagnostic pathway will be tailored to your symptoms and clinical findings. 

    • Treatment depends on the underlying diagnosis, symptom severity, and frequency of flare-ups. 

      For both conditions, treatment aims to ease pain, reduce swelling, and lower the chance of future flare-ups.

      Gout management 

      • Management of gout may include: 
      • Anti-inflammatory medicines, such as non-steroidal anti-inflammatory drugs (NSAIDs), to reduce pain and swelling
      • Colchicine or corticosteroids for acute flare-ups 
      • Long-term urate-lowering therapy to reduce crystal formation
      • Lifestyle support, when appropriate, such as changes to diet, alcohol intake or weight management

      Pseudogout management 

      Management of pseudogout focuses on symptom control and reducing joint inflammation: 

      • NSAIDs to relieve pain and swelling
      • Corticosteroids during acute episodes
      • Joint aspiration in selected cases to relieve pressure and improve comfort
      • Treatment for any related health conditions that may contribute to crystal buildup

      Ongoing monitoring may be recommended to help reduce recurrence and protect long-term joint function. 

    • Treatment aims to reduce inflammation, ease symptoms, prevent your joints, and help you stay active. 

      Your personalised treatment plan may include: 

      • Disease-modifying antirheumatic drugs, also called DMARDs (Methotrexate, Sulfasalazine, Leflunomide and Hydroxychloroquine). These medicines help slow the disease and protect the joints.
      • Biologic therapies, which target specific parts of the immune system (Eg. Adalimumab, Etanercept, Tocilizumab, Rituximab).
      • Targeted synthetic medicines, which help reduce inflammation by blocking certain immune system signals (eg Upadacitinib).
      • Anti-inflammatory medicines to help reduce pain and swelling.
      • Physical therapy to support strength, movement and function.
      • Lifestyle and exercise recommendations.
      • Ongoing monitoring and follow-up care.

      Our rheumatoid arthritis specialists tailor treatment plans to your disease activity, symptoms, and long-term health goals. 

    Private health insurance

    Mayo Clinic Healthcare London works with all major private health insurance providers, including AXA PPP, Aviva, BUPA, Health Partners Group, Vitality Health and WPA. 

    Self-pay arrangements are also available, and our team can guide you through pricing and appointment availability.

    Book a gout and pseudogout assessment

    If you have ongoing joint pain, swelling or repeated flare-ups, our rheumatology specialists can assess your symptoms and recommend next steps.

    Our team can help clarify your diagnosis and guide personalised gout and pseudogout treatment and management.

    Our team is here to answer your questions and provide personalised treatment options. Request an appointment with us today. or call +44 (0) 207 871 2575. 

     

    Medically Reviewed by

    Dr Anna Nuttall, Consultant Rheumatologist

    Home
    1. Home
    2. Specialties
    3. Rheumatology
    4. Gout and Pseudogout