My father's knee is suddenly hot and swollen. Could it be pseudogout?

Why older adults get pseudogout

Calcium pyrophosphate crystals build up in knee cartilage with age, often silently for years. A flare happens when crystals are shed into the joint and the lining reacts. Common triggers include a chest or urinary infection, dehydration, a recent operation such as a hip fracture repair, or a knock to the knee.

Families often notice that their parent suddenly will not walk, holds the knee bent, or seems more confused and unwell than usual.

Signs that need urgent care

Older people may not mount a high fever even with a serious infection, so take these signs seriously:

• Fever, shivering, unusual drowsiness or new confusion
• Inability to stand or walk at all
• Spreading redness or a wound near the knee
• Diabetes, steroid tablets, chemotherapy or other treatments that lower immunity
• A knee replacement on the affected side

If any apply, go to an emergency department the same day.

How the cause is found

A small sample of fluid is drawn from the knee and tested for crystals and infection. An X-ray often shows calcium lines in the cartilage, which supports pseudogout. Blood tests check for infection, kidney function and, sometimes, minerals such as calcium and magnesium, because some metabolic conditions are linked with pseudogout.

Treatment and support at home

Once infection is ruled out, the flare is usually treated with a steroid injection into the knee, a short course of tablets, or colchicine, chosen carefully around his kidneys, heart and other medicines. Keep him hydrated, help him rest with the leg raised, and use a wrapped cold pack. As the pain settles, encourage gentle walking with a frame or stick to avoid stiffness and loss of strength.

At Aman Hospital in Doha, Dr. Gelber examines the knee, can aspirate it in clinic, and reviews whether underlying arthritis needs its own treatment plan.