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Crystal Arthropathy

Notes »
disease
» Rheumatology
Crystal Arthropathy

Overview

Overview Crystal arthropathies are a diverse group of disorders characterized by deposition of various minerals in joints and soft tissues leading to inflammation. Two main types of crystal arthropathies:

  • Gout - The most common of all the crystal arthropathies, caused by monosodium urate crystal precipitation, and its prevalence appears to be increasing.
  • Pseudogout - caused by calcium pyrophosphate dihydrate

Clinical Presentation

  • Typically monoarthritis

Differential Diagnosis

Diagnosis

  • Synovial fluid analysis - identification of specific crystal types in synovial fluid
Synovial fluid analysis
 AetiologyColour and ClarityWBC (mm³)
NormalNormalClear and transparent<200
Non-InflammatoryOsteoarthritisYellow and transparent0 to 2000
InflammatoryGoutYellow and traslucent-opaque2000-100,000
SepticBacteriaYellow/green and opaque>25,000 - >100,000
HaemorrhageTraumaRed and Bloody200-2000

 

DIFFERENCE BETWEEN GOUT AND PSEUDOGOUT
 GoutPseudogout
AetiologyBuild up of uric acid crystal in jointsBuild up of calcium pyropohosphate crystals in joints
DiagnosisSynovial fluid examined under microscopy reveals the presence of uric acid crystalsSynovial fluid examined under microscopy reveals the presence of calcium pyrophosphate crystals
MorphologyNeedle shapedRhomboidal
BirefringenceStrongly negativeWeakly positive
TreatmentAllopurinol, ColchicineColchicine, corticosteroid injection

 

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