From Surf Wiki (app.surf) — the open knowledge base

Crystal arthropathy

Field	Value
name	Crystal arthropathy
field	Rheumatology

Crystal arthropathy is a class of joint disorders (called arthropathy) that is characterized by the accumulation of tiny crystals in one or more joints. Polarizing microscopy and the application of other crystallographic techniques have improved the identification of different microcrystals including monosodium urate, calcium pyrophosphate dihydrate, calcium hydroxyapatite, and calcium oxalate.

Types

Name	Substance	Birefringence
author=Choi H	title=Epidemiology of crystal arthropathy	journal=Rheum. Dis. Clin. North Am.	volume=32	issue=2	pages=255–73, v	date=May 2006	pmid=16716879	doi=10.1016/j.rdc.2006.03.002 }}	accumulation of uric acid	negative
vauthors=Canhão H, Fonseca JE, Leandro MJ	title=Cross-sectional study of 50 patients with calcium pyrophosphate dihydrate crystal arthropathy	journal=Clin. Rheumatol.	volume=20	issue=2	pages=119–22	year=2001	pmid=11346223	doi=10.1007/s100670170081	s2cid=19200365	url=http://link.springer.de/link/service/journals/10067/bibs/1020002/10200119.htm	display-authors=etal	access-date=2008-12-16	archive-url=https://web.archive.org/web/20010517183914/http://link.springer.de/link/service/journals/10067/bibs/1020002/10200119.htm	archive-date=2001-05-17	url-status=dead	url-access=subscription }} aka Pseudogout	accumulation of calcium pyrophosphate	weakly positive

Causes

Deposition of crystals in joints
Calcium pyrophosphate dihydrate crystal formation:
- Increased production of inorganic pyrophosphate
- Decreased levels of pyrophosphatase in cartilage
- Decreased levels of cartilage glycosaminoglycans
- Hyperparathyroidism
- Hemochromatosis
- Hypophosphatasia
- Hypomagnesemia
Hydroxyapatite deposition:
- Tissue damage
- Hyperparathyroidism
- Hypercalcemia
- Hyperphosphatemia
Calcium oxalate deposition:
- Enhanced production of oxalic acid due to enzyme defect
- Poor excretion of oxalic acid in kidney failure
- Excessive ascorbic acid intake in kidney failure

Risk factors

Obesity
Kidney failure
Hyperphosphatemia
Hyperparathyroidism
Hypercalcemia
Tissue damage (dystrophic calcification)

Diagnosis

Differential diagnosis

Septic arthritis
Type IIa hyperlipoproteinemia
Amyloidosis
Multicentric reticulohistiocytosis
Hyperparathyroidism
Spondyloarthropathy
Rheumatoid arthritis

Treatment

Steroid - options are intra-articular injection, oral steroid, or intramuscular injection of steroid. Intra-articular steroid + lido w/o (I like triamcinolone the best) 20 mg for small joints is perfect. For the intramuscular injection, I like 40 mg triamcinolone and 20 mg dexamethasone in the same syringe injected into the gluteus. For the oral steroid, I like Prednisone 40 mg every morning for seven days. The prescription will read prednisone 20 mg, two tabs PO Qa.m. x 7d, #14 0RF.
Colchicine 0.6 mg tabs - two tabs by mouth once and then one tab by mouth an hour later.
NSAID - I prefer 500 mg of naproxen twice a day for seven days. Just be careful with the NSAID and steroid combination. If prescribing oral steroids, I put patients on famotidine 40 mg one tablet by mouth twice a day for 14 days

Do not prescribe allopurinol for acute gout flair. Wait until they are six weeks resolved to initiate that, otherwise you can cause an acute flare/worsening of the gout. However, they are already on allopurinol, continue it.

References

Mcgill NW. (2000). "Gout and other crystal-associated arthropathies". Baillière's Clinical Rheumatology.
Choi H. (May 2006). "Epidemiology of crystal arthropathy". Rheum. Dis. Clin. North Am..
(2001). "Cross-sectional study of 50 patients with calcium pyrophosphate dihydrate crystal arthropathy". Clin. Rheumatol..
"Rheumatic manifestations of hereditary hemochromatosis".
"Hypophosphatasia Pathology".
(December 1989). "Pseudogout as a clue and complication in primary hyperparathyroidism". Surgery.

Wikipedia Source

This article was imported from Wikipedia and is available under the Creative Commons Attribution-ShareAlike 4.0 License. Content has been adapted to SurfDoc format. Original contributors can be found on the article history page.

inflammatory-polyarthropathies

Want to explore this topic further?

Ask Mako anything about Crystal arthropathy — get instant answers, deeper analysis, and related topics.

Research with Mako

Free with your Surf account

Content sourced from Wikipedia, available under CC BY-SA 4.0.

This content may have been generated or modified by AI. CloudSurf Software LLC is not responsible for the accuracy, completeness, or reliability of AI-generated content. Always verify important information from primary sources.

Report