A Mechanistic-Based Approach to the Physical Therapy Management for a Patient With the Diagnosis of Pseudogout: A Case Study

BACKGROUND: Pseudogout is an inflammatory arthritis typically affecting the knee. Consensus-based recommendations for physical therapy management approaches for patients presenting with pseudogout are lacking, requiring additional frameworks to guide the clinical decision-making process. A pain mechanistic-based approach can direct the physical therapy management approach for conditions such as pseudogout in which an established evidence base is lacking. CASE PRESENTATION: A 66-year-old male was referred by his physiatrist to physical therapy with bilateral anterior knee pain. The physician diagnosed pseudogout from the blood work and linked the increase in knee pain to this condition, prompting a referral for physical therapy. The patient was presumed to have a nociceptive pain presentation. Treatment focused on exercises directed at the peripheral source of pain and pain-relieving modalities. OUTCOME AND FOLLOW-UP: The patient was seen for 30 visits over a 19-week period. Lower Extremity Functional Scale score improved by 20, Patient-Specific Functional Scale score improved by 3.67/10, numeric pain-rating scale score improved by 3.67, and performance on the 5× Sit-to-Stand Test improved by 16 seconds. DISCUSSION: This case describes the application of a mechanistic-based approach to physical therapy management of a patient with pseudogout, for which research evidence is lacking. JOSPT Cases 2025;5(3):156-160. Epub 23 May 2025. doi:10.2519/josptcases.2025.0021