DEAR DR. ROACH: A couple of years ago a sports medicine doctor diagnosed pain in my right knee as chondrocalcinosis. I had never heard of this previously. He told me there was no surgical solution. I do rub Voltaren 2.32% (brand name, which I get from Mexico) on my knee when it is flaring with pain, which does help. The pain is especially bad when I am on my knees doing work around the house. I am 77 years old and otherwise in pretty good health. Why is Voltaren only available as 1% in the U.S.? - O.D.
ANSWER: Chondrocalcinosis, also called pseudogout, is caused by the deposition of calcium pyrophosphate crystals into the cartilage of joints, usually the knees. It can be diagnosed by X-ray. The surgeon is right that there is no surgical treatment, but there certainly is medical treatment. Oral Voltaren (diclofenac) is an effective treatment. The joint can also be treated with injection of steroids directly into it. Colchicine can be used in people who cannot tolerate anti-inflammatories, such as diclofenac. Diclofenac applied topically is not well absorbed into the joint or blood and is not going to be as effective (even though there is a prescription strength 2.5% available). Most experts recommend treating during flares, and it sounds like it's during flares when you really need relief.