Microcrystalline arthropathy: issues and challenges of differential diagnosis

Abstract

The basic information about the crystal-induced arthritis and their differential differences are presented in a review article. Microcrystalline arthritis include gout (inflammation associated with the deposition of crystals of sodium urate), crystals of calcium pyrophosphate deposition disease — pyrophosphate arthropathy disease and deposits of basic calcium phosphate. The deposition of crystals in joint tissues leads to the development of immune inflammatory. The basic clinical symptoms of crystal-induced arthropathy are described. Significant value in the differential diagnosis of microcrystalline arthropathy belongs to determination of sodium urate and calcium pyrophosphate crystals in synovial fluid by polarization microscopy. The favorite and most frequent localization
of the deposit crystals of calcium pyrophosphate is a wrist and knee joints, as well as the small joints of the hands (wrist band). The metatarsophalangeal joint of the I-st and toe joints of the foot arch are affected most commonly in acute gout attack. The disease of deposits of basic calcium phosphate is associated with damage to the shoulder joint. Сhronic gout is characterized by relapsing course and tophi formation that leads to the destruction of joints. Chronic forms of pyrophosphate arthropathy often mimic of osteoarthritis. Correct differential diagnostics and proper establishment of microcrystalline arthritis allows to assign of adequate therapy and avoid the destructive effects of crystals in the joint tissue.