The knee is the most commonly involved joint-pseudogout (calcium pyrophosphate dihydrate deposition disease) presents very similarly to gout, however these patients tend to be older and the knee is more commonly involved (the knee is the most common joint involved followed by the wrist, ankle and elbow). the average attack is not as severe as acute gout. synovial fluid examination shows rhomboidal, weakly positive birefringent crystals of calcium pyrophosphate dihydrate. treatment for an acute attack is identical for acute gout: nsaids, steroids, acth, or oral colchicine, although colchicine is not as effective as with gout. prophylaxis is generally less effective. (chapter 114)
