In a patient with pseudogout, the knee is the joint most commonly involved, followed by the wrist, ankle, and elbow. The average attack is not as severe as acute gout. In general, these patients are between the sixth and eighth decades that have a previous history of arthritic attacks. Joint fluid examination shows the weakly positive birefringent crystals of calcium pyrophosphate dihydrate. The crystals appear rhomboidal on regular light microscopy. Treatment for an acute attack is similar to the therapy for acute gout: NSAIDs or oral colchicine, although the latter is not as effective as with gout.