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Identification of crystals in synovial fluid
| The first 150 words of the full text of this article appear below. |
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Introduction |
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Synovial fluids can contain a number of crystals and other
particulate matter. Some of these, particularly monosodium urate monohydrate (MSUM) and calcium pyrophosphate dihydrate (CPPD) crystals,
are pathogenic; others, including cholesterol and other lipid particles
and the basic calcium phosphates (BCPs), including apatites, are of
doubtful significance. Table 1 lists the main forms of particulate
matter that have been identified in synovial fluids.
| Table Removed (Available Only in the Full Text) |
In the case of MSUM and CPPD crystals it is clear that the
identification of these crystals in a synovial fluid that also has a
high polymorphonuclear cell count (indicative of acute inflammation) is
the only certain way to diagnose an attack of gout or pseudogout respectively.1 Furthermore, this is one of the few tests
that has been shown to change clinical practice in
rheumatology,2 and it is apparent that the consequences of
getting the diagnosis wrong can be severe.3 Therefore,
accurate identification of MSUM and CPPD
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