Dr.Artis was so amazing. After going to two other podiatrists who gave me no support or hope, Dr. artis made me feel like there can be change for me. She was so patient, kind and informative. I’m actually excited to go back and get my results.
When patients present with a hot, swollen, acutely painful joint, gout is often the first diagnosis that comes to mind and for good reason, given how prevalent it is. But another form of crystal arthritis, pseudogout, causes a clinically similar presentation and is far more common than most patients and even many clinicians appreciate. Pseudogout is caused by the deposition of calcium pyrophosphate dihydrate (CPPD) crystals rather than monosodium urate crystals a distinction that completely changes the long-term management approach, since there is currently no medication that lowers calcium pyrophosphate levels the way allopurinol lowers uric acid. At Healthy Feet NYC, we encounter both conditions regularly and use precise diagnostic tools to distinguish between them ensuring that every patient receives a treatment plan matched to the actual crystal causing their inflammation.
The distinction between gout vs pseudogout begins with crystal chemistry. Gout is caused by monosodium urate (MSU) crystals that form when serum uric acid exceeds its solubility threshold, most often affecting the first MTP joint of the big toe, the ankle, and the midfoot particularly in men. Pseudogout is caused by calcium pyrophosphate dihydrate (CPPD) crystals that deposit in joint cartilage and synovial fluid, most often affecting the knee, wrist, and ankle though it can involve virtually any joint. On physical examination, both conditions produce acute joint redness, warmth, swelling, and severe pain that is clinically indistinguishable. Definitive differentiation requires joint aspiration with synovial fluid analysis under polarized light microscopy: MSU crystals appear as needle-shaped, negatively birefringent crystals under polarized light, while CPPD crystals are rhomboid-shaped and weakly positively birefringent a distinction that is unambiguous to a trained observer and completely resolves the diagnostic question.
Acute management of gout and pseudogout is similar because both involve crystal-induced joint inflammation driven by the same inflammatory pathways — NSAIDs, colchicine, and corticosteroids are effective for both. However, long-term management diverges completely. Gout has a well-established, highly effective long-term treatment in urate-lowering therapy, which gradually dissolves existing MSU crystals and prevents new deposition a pharmacological solution that fundamentally alters the disease course. Pseudogout currently has no equivalent: there is no approved medication that lowers calcium pyrophosphate levels or prevents CPPD crystal deposition. Long-term management of CPPD disease therefore focuses on identifying and treating associated metabolic conditions that predispose to pseudogout including hyperparathyroidism, hemochromatosis, hypomagnesemia, and hypothyroidism joint protection, and treatment of acute flares as they occur. Prescribing allopurinol to a patient with pseudogout who does not have coexistent hyperuricemia will have no impact on their joint disease whatsoever.
TESTIMONIAL
Dr.Artis was so amazing. After going to two other podiatrists who gave me no support or hope, Dr. artis made me feel like there can be change for me. She was so patient, kind and informative. I’m actually excited to go back and get my results.
Everyone was super friendly. Doctor Rick’s explained everything thoroughly.
Dr Bell was incredibly thorough and personable. Gave me great information and useful information for my next steps. A great experience!
“Fast, professional, and very clean office. I was checked in and seen within 10 minutes of my scheduled time. Dr. Ricks was straight to the point but thorough. The front desk staff was also incredibly helpful.
All of the staff are super welcoming and professional! Bianca took excellent care in getting my X-rays. Dr. Ricks was thorough in explaining my diagnosis and next steps. Highly recommended!!
Well before I came in today to see Dr. Ricks my foot in pain was 9/10 and now I feel good 🙏🏿🤩 thanks
Behind every great care experience is a team that truly listens. Our doctors are committed to understanding your needs, delivering personalized treatment, and supporting you every step of your health journey.
Dr. Farah Alani is a New York City foot and ankle surgeon at To Healthy Feet Podiatry, a boutique podiatry practice located in the heart…
Dr. Alison Bell was born in Manhattan and is a Public Health graduate of Charles R. Drew University. She obtained her medical degree from Kent…
Dr. Roxann Clarke is a graduate of Hampton University in Virginia, where she obtained her Bachelor of Science in Biology and her Master of Science…
Dr. Ricks is a board-certified fellowship-trained podiatric surgeon committed to delivering top-tier foot and ankle care. From New Jersey, she a Bachelor’s in…
As the Chief Operating Officer of To Healthy Feet Podiatry, Tiffany provides leadership to ensure all administrative are producing optimal results. Dr….
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